The placenta is the baby’s life support system in the womb. A placental abruption is a very serious problem which can cause injury to the mother and baby.
What is a placental abruption?
Placental abruption is a serious medical condition where the placenta detaches from the wall of the mother’s womb before the baby is born. The placenta may partially or completely detach from the womb.
Placental abruption affects less than 1% of pregnancies. However, if it does happen it requires immediate medical attention. In very severe cases placental abruption can lead to developmental problems in the baby or even stillbirth. Placental abruption can also be a threat to the mother’s health.
How serious is a placental abruption?
A placental abruption is a serious risk to the health of mother and baby.
In severe cases, placental abruption could put the baby at risk. The baby could be deprived of oxygen (‘hypoxia’) or nutrients in the womb. This can lead to brain damage or even the baby’s death. Severe bleeding and infection may also place the mother’s life at risk.
Causes of placental abruption
Doctors do not know exactly what causes placental abruption. However, some risk factors are associated with an increased risk of an abruption occurring.
There is a risk of placental abruption during any pregnancy, but doctors know it is more likely if the mother:
- has experienced placental abruption in a previous pregnancy
- suffers a severe abdominal trauma (injury) during pregnancy, for example if she is in a car accident, fall, or assault
- is expecting twins or triplets (multiple births)
- develops pre-eclampsia (a condition developed during pregnancy, causing high blood pressure)
- suffers an intrauterine infection (an infection of the womb) during pregnancy
- suffers from chronic high blood pressure, before the pregnancy
- uses cocaine or amphetamines during pregnancy
- is a smoker.
Please note that placental abruption can happen even if none of the above factors are present. If you’re pregnant and have any of the above risk factors, your doctor/midwife should provide you with the right advice for your situation.
Signs and symptoms of placental abruption
The typical signs and symptoms of placental abruption may include:
- back pain
- stomach pain or tenderness
- vaginal bleeding
- uterine contractions that do not relax.
Your doctor/midwife should recognise these symptoms as potential signs of placental abruption and refer you to hospital for emergency obstetric care.
If you tell your doctor you are experiencing one or more of these symptoms, they should take you seriously and try to find out what’s wrong by taking a full history from you, considering any relevant medical history and examining you.
Placental abruption can happen suddenly and it can affect your baby’s health in the womb. This can happen very quickly, particularly if you suffer from a severe abruption and your baby’s oxygen supply is limited. It is therefore important that your doctors make a prompt diagnosis and provide the correct care.
Revealed placental abruption
Vaginal bleeding during pregnancy can be a sign of placental abruption. If you experience vaginal blood loss during your pregnancy, your doctor should recognise that this could cause a problem to your baby’s health and yours.
Concealed placental abruption
There could be little or no vaginal bleeding during a placental abruption. If there is no, or very little, blood loss, this might indicate a ‘concealed’ or ‘silent’ abruption. Concealed abruptions happen when blood becomes trapped between the wall of the womb and the placenta. So, the blood cannot leave the mother’s body.
Because the blood is trapped, this type of placental abruption can happen with little to no noticeable bleeding. Concealed abruptions are normally diagnosed when a woman reports back pain or abdominal pain. If you tell your doctor/midwife you are experiencing pain during your pregnancy, they should take you seriously. Your doctor/midwife should listen to you if you tell them something feels wrong during your pregnancy.
The symptoms of placental abruption vary from person to person. Some mothers might notice a significant amount of vaginal bleeding – in other cases there may be no vaginal bleeding at all. Placental abruption can also develop gradually. If this happens, the mother may experience persistent light vaginal bleeding (spotting). The mother should seek the advice of her doctor/midwife immediately.
Asymptomatic placental abruption
Sometimes, there might be no symptoms of a placental abruption. This is called an ‘asymptomatic placental abruption’. This type of placental abruption can happen without any pain or bleeding. It may have no effects on a baby’s development or labour. Asymptomatic abruptions can be diagnosed after the baby is born when the placenta is delivered and examined. The baby and mother should be carefully checked over for any problems.
Always speak to your doctor or midwife if you are worried about any aspect of your health during your pregnancy, as recommended by the NHS. If you are not happy with the advice you receive from your doctor or midwife, you can go to hospital for a detailed examination. Doctors and midwives are trained to recognise potentially life-threatening complications during pregnancy, such as placental abruption, and they should take your concerns seriously if you are worried there may be a problem.
Effect of placental abruption on the baby and mother
Placental abruption poses a risk to the health of mother and baby and can be a life threatening condition. Placental abruption can affect the health of the baby in the womb, and can lead to:
- premature birth (and associated complications)
- developmental problems
- brain injury, such as cerebral palsy (for example, if the baby is starved of oxygen in the womb)
- in very severe cases placental abruption can cause stillbirth.
Placental abruption can cause severe brain injury which may lead to the baby’s death shortly after delivery. The risk of this happening is very small. It’s one reason why placental abruption is a very serious condition and is an obstetric emergency. This means that doctors and midwives must act quickly to protect the health of the mother and baby.
During a very severe placental abruption, the baby may be starved of oxygen (‘hypoxia’). If a baby is starved of oxygen, even for a very short time, and can result in the baby suffering from cerebral palsy.
Placental abruption can cause the mother to bleed excessively either before the baby is born or after the baby is born. The mother’s condition should be established and the appropriate treatment plan put in place. Placental abruption can cause a mother’s death depending on the extent of the abruption and the time taken to seek medical assistance.
Treatment for placental abruption
Treatment for placental abruption depends on how severe your condition is, and how close to your due date you are.
If your baby is at high risk, your doctor may recommend immediate delivery. An emergency caesarean section is usually the treatment of choice. If you are close to your due date or the placenta is fully detached, doctors may recommend this route. If your placenta becomes fully detached from your womb, there is no way to reattach it. Your doctor should explain the risks of the abruption to you and the baby so that you can make an informed decision about what you want.
If your baby is very premature, and the placenta is only partially detached, you may be kept in the hospital to rest. Your doctors/midwives should monitor your condition and the development of your baby. During this time, your baby should be closely monitored for signs of distress in the womb. If your condition becomes worse, your doctor should recommend an appropriate and safe mode for delivering the baby.
Medical care during placental abruption
The majority of placental abruptions are managed well and the pregnancy continues to a good outcome.
However, in rare cases, placental abruption can have devastating consequences. It can lead to severe brain injury or stillbirth, and birth injury to the mother. Such a traumatic birth experience can have a lasting psychological and physical impact on mothers, their partners and families.
You are entitled to answers about what happened during your care. If something went wrong during your pregnancy or the birth of your child, it’s very natural to want an explanation about what happened and why. There are channels you can go through, such as:
- making a complaint to the NHS – the local PALS (Patient Advice and Liaison Service) office is always happy to assist with complaints
- instructing a solicitor to investigate the possibility of making a claim against the doctor/hospital.
If you suffered from a placental abruption and are worried about the care you received, and think it might have caused a problem, we can help. Our birth injury claims specialists understand what you’re going through, and we can help you get answers about your care. We’ll listen to your experiences, and help you find out what happened during your pregnancy and delivery.
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