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Signs of Placental Abruption And Their Management

Medically reviewed by Jobelle Ann Dela Cruz Bigalbal, MD · General Practitioner


Written by Lorraine Bunag, R.N. · Updated Jul 14, 2022

    Signs of Placental Abruption And Their Management

    While in the womb, the baby gets their oxygen and nutrients from the placenta, a temporary organ connecting them to the uterus. Typically, the placenta detaches after the baby’s birth. However, there are cases when the separation happens abruptly or prematurely, a condition referred to as placental abruption. What are the signs of placental abruption, and how can it affect both the mother and the child?

    Placental Abruption, Defined

    Placental abruption happens when the placenta prematurely separates from the uterus. Reports say it is an uncommon yet serious complication of pregnancy. 

    You see, the placenta has many blood vessels. If the placenta pulls away from the wall of the uterus during pregnancy, the vessels may bleed. The larger the area that detaches, the heavier the bleeding is. 

    The Signs of Placental Abruption

    Placental abruption is most likely to occur in the later stages of pregnancy, particularly in the last few weeks before giving birth.

    Signs and symptoms include:

    • Sudden or sharp abdominal or back pain
    • Uterine tenderness or rigidity
    • Uterine contractions that are longer and more intense than those that happen during labor
    • Decreased fetal movement
    • Vaginal bleeding, although there may not be any since the blood is trapped between the uterine wall and placenta

    Causes and Risk Factors

    Now that we have a clearer understanding of the signs of placental abruption, let’s talk about the causes and risk factors. 

    In most cases, doctors don’t know the exact cause of premature placental separation. Still, experts have identified the following known reasons:

    • Abdominal trauma, which might force the placenta to pull away. Trauma may occur after an assault or car accident. 
    • Uterine decompression, which is the sudden loss of amniotic fluid from the uterus. Decompression may suck out the placenta from the uterine wall. 

    Other Risk Factors 

    The following may increase a woman’s risk of experiencing the signs of placental abruption:

    • Prior pregnancy
    • Prior placental abruption
    • Multiple pregnancies
    • Advanced maternal age
    • Substance abuse and smoking during pregnancy
    • Hypertension 
    • Blood conditions, especially those that affect the blood’s clotting ability
    • Excessive amniotic fluid and amnioreduction, the procedure that removes excess amniotic fluid
    • Amniocentesis, a test where the doctor inserts a needle through the abdomen into the amniotic sac to draw amniotic fluid
    • External cephalic version, where the doctor massages the abdomen to turn the baby from a breech position to a head-down position. Very rarely, the massage dislodges the placenta. 

    When to Seek Medical Help

    Consult your doctor if you develop signs of placental abruption, or you have any bleeding during pregnancy. However, if the bleeding is moderate to severe, especially when you also have other symptoms, such as pain, go to the hospital immediately. 

    Treatment 

    Note that there’s no way to repair or reattach the placenta once it separates from the uterine wall. Treatment and the outcome usually depend on the amount of blood loss, the overall condition of the baby, the severity of placental separation, and the gestational age of the baby. 

    • If the baby is still too young to be born and the placental abruption is mild, the doctor may monitor your condition until you reach the 34th week. In this case, you may be allowed to go home and rest. 
    • Now, even if the baby is too young, but the placental separation is severe, or it poses a risk to you or your baby’s health, the doctor may recommend immediate delivery. 
    • If the baby’s condition is stable and they are near full-term, the doctor may recommend a closely monitored vaginal delivery. 
    • The doctor may also opt for an emergency C-section if the baby is near full-term, but the abruption is getting worse. 

    Prevention

    There’s still no one way to prevent placental abruption. The best thing to do is lower the woman’s risk by making sure she has a healthy pregnancy.

    Some of the steps to take are:

    • Avoiding smoking or drugs
    • Making sure the underlying conditions are controlled, such as hypertension and diabetes
    • Being very cautious to prevent accidents that might cause abdominal trauma

    Learn more about Being Pregnant here

    Disclaimer

    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Jobelle Ann Dela Cruz Bigalbal, MD

    General Practitioner


    Written by Lorraine Bunag, R.N. · Updated Jul 14, 2022

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