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Read MoreUnderstanding Placental Abruption: Causes, Symptoms, and Treatment Options
Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on October 10th, 2023.
Key Takeaways
This emergency occurs in approximately 1% of pregnancies when the placenta detaches from the uterine wall before delivery, most commonly after 20 weeks gestation.
Classic symptoms include sudden, dark red vaginal bleeding with severe abdominal pain that doesn't come and go like contractions—the uterus becomes hard and tender to touch.
Women with previous abruption face a 10-15% recurrence risk in subsequent pregnancies, while cocaine use increases risk 10-fold compared to non-users.
Partial abruption before 34 weeks may be managed with corticosteroids and bed rest, while complete separation or fetal distress requires immediate cesarean delivery regardless of gestational age.
Severe cases can cause life-threatening hemorrhage leading to disseminated intravascular coagulation (DIC), where blood loses its ability to clot properly.
Placental abruption is a rare but serious complication that can occur during pregnancy. It happens when the placenta, which provides nutrients and oxygen to your baby, separates from the uterine wall before delivery. Although placental abruption affects only about 1% of pregnant women, it can be dangerous for both mother and baby if not treated promptly.
What Causes Placental Abruption?
In most cases, the exact cause of placental abruption is unknown. However, certain factors can increase your risk, including:
Previous placental abruptions
Smoking or using drugs like cocaine
High blood pressure
Problems with the amniotic sac
Advanced maternal age (35 or older)
Carrying multiple babies
Abdominal trauma
Recognizing the Symptoms of Placental Abruption
Placental abruption usually occurs suddenly in the third trimester, but it can happen any time after 20 weeks of pregnancy. Symptoms may include:
Vaginal bleeding (amount can vary)
Abdominal or back pain
Uterine tenderness or frequent contractions
Abnormal fetal heart rate
In some cases, placental abruption may occur gradually (chronic abruption), causing intermittent light bleeding, low amniotic fluid levels, and slow fetal growth.
Diagnosing Placental Abruption
If you experience any symptoms of placental abruption, seek medical attention immediately. Your doctor will perform a physical exam, run blood tests, and may use an ultrasound to assess your condition. Keep in mind that ultrasounds don't always detect placental abruptions.
Treatment Options for Placental Abruption
Treatment for placental abruption depends on the severity of the condition, gestational age, and the health of both mother and baby. If you're less than 34 weeks pregnant and the abruption is not severe, you may be monitored in the hospital or given steroids to help your baby's lungs develop faster.
If you're more than 34 weeks pregnant, you may still be able to have a vaginal delivery if the abruption is mild. However, severe cases may require an emergency cesarean section (C-section) to ensure the safety of both you and your baby.
Potential Complications of Placental Abruption
While small placental abruptions may not cause significant problems, large or complete abruptions can lead to serious complications for both mother and baby, such as:
Severe maternal blood loss
Shock
Organ failure
Premature birth
Developmental issues in the baby
Stillbirth
Although placental abruption can be a frightening experience, understanding the condition and seeking prompt medical care can help ensure the best possible outcome for you and your baby.
The Bottom Line
Immediate medical evaluation is essential when experiencing sudden bleeding with severe abdominal pain during pregnancy, as this condition can rapidly progress from mild to life-threatening within hours. Treatment success depends on quick recognition and appropriate intervention based on severity and gestational age. If you're experiencing concerning symptoms during pregnancy, Doctronic can help you assess the urgency of your situation.
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