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Placental Abruption

By Stacey Bucklin
CP Family Network Editor

Placental abruption is the separation, either partially or completely, of the placenta from the uterine wall before delivery. Although this condition is relatively rare, occurring in 1 out of every 100 pregnancies, the premature detachment of the placenta can have serious health consequences for a mother and her unborn child, including the risk of cerebral palsy.

Symptoms of Placental Abruption

Placental abruption is an extremely serious condition that most commonly occurs during the last few months of gestation, although it can occur any time after the 20^th week of a woman’s pregnancy. If you experience these symptoms, contact your doctor or go to the emergency room immediately:

Back pain
Abdominal pain
Vaginal bleeding
Frequent uterine contractions
Continuous uterine contractions (no relaxation in between)

It is not possible to diagnose the severity of placental abruption by the amount of bleeding from the vagina. Blood may be trapped between the placenta and wall of the uterus, where it is prevented from exiting the body. Any vaginal bleeding during pregnancy should be brought to your doctor’s attention immediately.

Placental Abruption Diagnosis

Diagnosing placental abruption may be difficult at first. Doctor’s will make a diagnosis based on a physical exam, a medical history, and a process of elimination.

Ultrasound

Doctors may conduct an ultrasound in order to see if the placenta has separated from the uterine wall. However, this test is only successful in detecting about 50% of placental abruptions and a negative test does not necessarily mean you are in the clear.

Fetal Monitoring

Your doctor should attach a fetal heart monitor to check your baby’s heart rate and check for signs of fetal distress. Fetal heart monitors can also be used to track contractions of the uterus.

Test for Anemia

If you suspect you are experiencing a placental abruption, you should be checked for anemia. A woman experiencing placental abruption can become anemic due to excessive blood loss.

Risk to Fetus

The placenta nourishes a growing fetus. If it is compromised, such as in placental abruption, the unborn baby may be deprived of oxygen. This can cause stillbirths, premature births, or future growth problems. Oxygen deprivation can also cause brain damage, including cerebral palsy.

When a baby’s brain is deprived of oxygen during pregnancy or birth, parts of the brain may begin to die. This sort of brain damage can result in developmental problems, motor skill issues, and other symptoms of cerebral palsy later in life.

Treatment of Placental Abruption

Placental abruption is not typically fatal to a mother, although it can be for her unborn child. Doctors will determine an appropriate course of action based on the following factors:

Severity of the abruption
Impact on the fetus (is the baby in distress?)
Proximity to the baby’s due date

If your placenta has separated from the wall of your uterus, your doctor will monitor you for shock and will monitor your baby for signs of distress, including a decline in fetal heart rate. Mild abruptions may heal on their own. You may also receive IV fluids or blood transfusions to replace blood loss.

In some cases, the mother will be kept at the hospital for close observation. Depending on how far along the pregnancy is, vaginal delivery may be a safe option. However, emergency Cesarean sections are often required.

Placental Abruption Prevention

In many cases, there is little you can do to prevent placental abruption. However, proper prenatal care is the first step in preventing a wide variety of pregnancy complications. Avoid drinking alcohol, smoking, or using recreational drugs during your pregnancy. Alert your doctor to preexisting conditions such as high blood pressure and diabetes and be sure to monitor these regularly.

Placental abruption may also be caused by trauma such as a car accident or fall. If you experience any sort of trauma during your pregnancy, notify your doctor as soon as possible.