Placental Abruption

Placental abruption is the separation of the placenta from the uterine lining. This condition usually occurs in the third trimester but can occur any time after the 20th week of pregnancy. Only about 1% of all pregnant women will experience placental abruption, and most can be successfully treated depending on what type of separation occurs.

What are the signs & symptoms of placental abruption?

The signs and symptoms of placental abruption include one or more of the following:

  • Abdominal pain
  • Uterine tenderness
  • Rapid contractions
  • Vaginal bleeding in the third trimester

Any vaginal bleeding in the third trimester should be reported to your doctor immediately. Other causes for vaginal bleeding could be placenta previa. Your doctor will know the proper diagnosis.

What actually happens in placental abruption?

The placenta is part of your baby's life support system. It transfers oxygen and nutrients to your baby. When the placenta separates from your uterine lining before labor it can interrupt the transportation of oxygen and nutrients to your baby.

What is the treatment for placental abruption?

There are three types of separation: slight, moderate and severe placental abruption. Treatment depends on the severity of the separation.

Slight separation: Bed rest is prescribed and should be the only thing needed to stop the bleeding. Your health care provider will continue to monitor for symptoms.

Moderate separation: Bed rest and close monitoring is prescribed. In some cases transfusions and other emergency treatment may be needed as well.

Severe separation: Prompt medical action, including transfusions and immediate delivery is needed.

Any of the three types of placental abruption can lead to premature birth and low birth weight. In cases where severe placental abruption occurs, approximately 15% will end in fetal death.

What causes placental abruption?

The causes of placental abruption are not completely known. However, women are more at risk for this condition if they:

  • Smoke
  • Use cocaine during pregnancy
  • Are over the age of 35
  • Have preeclampsia or hypertension
  • Are pregnant with twins or triplets
  • Have had a previous placental abruption

When should I call the doctor?

You should call your health care provider immediately if you experience bleeding in your third trimester. Only your physician can make a proper diagnosis for the cause of late term bleeding. The outcome of a placental abruption diagnosis is improved with fast and accurate treatment.

Reprinted with permission from American Pregnancy Association.