The placenta processes your baby’s nutrients, waste and oxygen by bridging your baby’s blood circulation with that of your own. It sits inside the womb alongside your baby, and is attached to the wall of the womb. It is linked to the baby by umbilical cord, which is attached to the baby’s abdomen.
Placental abruption (discussed here) and low-lying placenta are conditions linked to the placenta that can cause premature birth.
Placental abruption is a serious condition in which the placenta starts to come away from the inside of the womb wall before the baby has delivered. This is an emergency because it means that the support system for the baby is failing.
Studies show that placental abruption affects up to 1% of pregnancies (though it is suspected that the actual figure may be higher as it may not always be diagnosed). In this condition some or all of the placenta separates from the wall of the womb before the baby is delivered. This can be caused by an impact such as a car crash, or may be related to a condition such as pre-eclampsia or fetal growth restriction, also know n as Intrauterine growth restriction or IUGR.
When placenta abruption happens the placenta is damaged and the baby may not be supported to develop properly.
Symptoms of placental abruption
- pain in the back and abdomen
- tender womb
- vaginal bleeding.
If you are suffering from any of the symptoms above get medical help immediately because they may signify an emergency.
In most cases of placental abruption it will be diagnosed from obvious blood loss.
However it could also be a concealed or ‘silent’ abruption, in which the blood is trapped between the wall of the womb and the placenta so there is little or no bleeding. In this case it would be diagnosed when the woman reports pain in the back or abdomen.
The level of pain depends on the severity of the abruption. A less severe abruption may feel like a bruise. A severe abruption will be very painful.
Risk factors for placental abruption
Placental adruption is more likely if the mother:
- had a previous placental abruption
- is a smoker
- is a cocaine or amphetamine user
- has chronic high blood pressure
- has pre-eclampsia
- has had a blow to the stomach or an indirect trauma that may have affected the placenta
- has an intrauterine infection.
To reduce your risk avoid smoking in pregnancy and taking street drugs in pregnancy.
What does placental abruption mean for me and my baby?
The effects and treatment of placental abruption depend on how severe it is. If you are under 34 weeks and only a small part of the placenta has broken away from the womb you will be monitored closely to make sure the baby is growing properly and to watch for signs of labour starting.
If there is a risk of your baby not growing properly then labour may be induced.
If the abruption is more severe, you are losing lots of blood and the baby is in distress or at risk of not growing properly you may need to have your labour induced or have an emergency caesarean.
In addition to any problems that the baby may have from the placental abruption, there are health risks of being delivered early. These depend on how far into the pregnancy you are.
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/basics/epidemiology.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/basics/aetiology.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117.html
- J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
- RCOG (2011) Antepartum Haemorrhage, Green-top guideline 63, Royal College of Obstetricians and Gynaecologists
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/diagnosis/history-and-examination.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/treatment/step-by-step.html
ℹLast reviewed on September 1st, 2016. Next review date September 1st, 2019.
By Anonymous (not verified) on 30 Oct 2017 - 08:31
Currently in hospital (35weeeks +3days, baby number 1). Has quite severe blood loss 2days ago which has now settled, was having lots of contractions but now settling. Didn’t have any pain or warning signs. No risk factors or trauma. The doctors are planning to send me home soon but this idea terrifies me as I’m obviously v high risk for having further placental abruption and I’ve read that in 20% of cases there is no bleeding - so if this were to happen at home I would have no way of knowing and she would probably be stillbirth? I’m not sure if I’m overreacting or if there is any situation I should be pushing for? Or some questions I should be asking to reassure myself? I’m happy to sit in hospital for as long as needed on a monitor but I’m don’t think that’s going to happen!
By Midwife @Tommys on 30 Oct 2017 - 13:59
Hi. I would suggest that you talk to the doctors about your concerns and ask them to explain the risks to you. Have they diagnosed placental abruption or could this be antepartum haemorrhage with unknown cause? If the CTG is normal then home may be your best option but I am reluctant to advise without access to all the test results. Wish you all the best from Tommy's midwives
By Anonymous (not verified) on 29 Oct 2017 - 10:01
I woke up sober on 18th Oct but at 8.30am I started bleeding heavily n on arrival to Hosp.a cs was done at 32weeks.I almost died n was taken to ICU.I lost the baby girl on 19th due to placenta abruption.will I ever see another baby?Am worried
By Midwife @Tommys on 30 Oct 2017 - 12:01
Hi. I am so sorry that you lost your beautiful baby girl so soon. You are welcome to call us if you need some support or just to talk 0800 0147 800. Please talk to the doctors and discuss the future. They will be able to explain if there is any reason why you should not have another pregnancy. Best wishes from all at Tommy's
By Anonymous (not verified) on 7 Oct 2017 - 06:33
Two daughters one at 29 weeks (has some learning delays she is 12) my other daughter 36 and 5. Two days from being "full term" I am not a smoker I'm not a cocaine or amphetamine user. I was pretty healthy and active during both pregnancies. According to testing my placenta I was 99% abrupted. They lost the fetal heart rate so while I had entered the OR as delivering awake soon it became emergent. My question is this is there any correlation between the placenta detaching for an undetermined amount time and any cognitive delays or is it simply due to the complications of being 2.5 pounds. This is a question I have been wondering for years and would love to finally get some answers. I know how blessed I am that she survived and she's amazing but the massive difference between my girls the other has been identified as gifted both times I abrupted. Also are there any genetic reasons that this may happen?
By Midwife @Tommys on 9 Oct 2017 - 16:00
Any abruption is a serious emergency as I am sure you realise having had 2 daughters affected. If the fetal heart rate slowed this could suggest that there was some degree of oxygen deficiency to the baby which may account for cognitive delays she has experienced. Unfortunately although you have identified some high risk factors this could in fact happen to anyone. Best wishes to you and your daughters x
By Anonymous (not verified) on 28 Sep 2017 - 21:14
Is it considered a placental abruption before 20 weeks? My OB only stated that my placenta tore away from the uterine wall (13 weeks along). In this case is it considered a subchorionic hemorrhage?
By Midwife @Tommys on 29 Sep 2017 - 12:33
I am so sorry for your loss.
Yes a placental abruption is considered to be after 20 weeks.
In your case the type of haemorrhage would need to be confirmed by the scan findings as it depends on the location.
By Anonymous (not verified) on 20 Sep 2017 - 02:57
I was diagnosed at 9 weeks I started out spotting some with bad cramping put on bed rest then at 18 weeks was hospitalized due to extreme bleeding almost lost him then I made it to 21 weeks in the hospital and lost him on my daughters bdaythis was 10 years ago and the pain is still so raw
By Midwife @Tommys on 20 Sep 2017 - 10:13
Hi Jeane, we are so sorry to hear about the loss of your son 10 yrs ago. Such huge life experiences will always stay with us, but the love you have for your son will always live on. Thank you so much for sharing your story with us and please do feel to get in contact with us via email or telephone if you wish to talk things through with us- we are happy to help! Sending our love to you and your family. Please take good care of yourself!
By Anonymous (not verified) on 11 Aug 2017 - 23:42
My abruption was back in 2001 I went into normal labour, no other signs that anything other than a normal labour was taking place. Within 2 hours I had lost all my strength and energy but managed to call my midwife by then it was 1 long continuous contraction no let up just continual pain. My son was born asleep 9 hours later (normal birth)
By Midwife @Tommys on 14 Aug 2017 - 15:20
It's a long time ago but it never leaves you. So sorry and thanks for sharing this x
By Anonymous (not verified) on 11 Aug 2017 - 09:24
I 've had two placental abruptions first ending in still birth second in an emergency c section and premature birth. Other symptoms are light handedness and vomiting. This condition is rarely spoken of and women are not told about it or to watch for the symptoms like other well known complications during pregnancy which i think it should be so they are made aware.
By Anonymous (not verified) on 13 Aug 2017 - 03:51
I also went through placental abruption two years ago which ended in still birth at 37 weeks. I am now expecting baby number two, only a few weeks pregnant and I am terrified.
By Midwife @Tommys on 14 Aug 2017 - 15:23
Thank you for contacting us. If we can support you through this pregnancy, you are welcome to call us on 0800 0147 800. Best wishes x
By Anonymous (not verified) on 11 Aug 2017 - 09:11
This article is extremely useful in outlining the symptoms of abruption, and I feel it should be produced intonleaflets and distributed to all hospitals. I lost my little girl in 2012 to abruption caused by Pre Eclampsia. I went in complaining about horrific pain in the back and abdomen, and what felt like contactions every minute or so.
I also had high BP and protein and blood in my urine. The hospital told me to stop being "soft" and go home as I was in slow labour and it would get worse. The third day I went in complaining of this pain, they informed me my baby had died at full term.
They were so uneducated about abruption and Pre Eclampsia. I presented all the symptoms, yet they did nothing.
Tommys do amazing work and it's thanks to Tommys that I now have 3 beautiful, living children all born high risk at St. Mary's.
By Midwife @Tommys on 11 Aug 2017 - 10:09
I am so terribly sorry to hear of your experience, what you went through, and the loss of your baby. If we can support you at all then please do be in touch. Thank you so very much for your feedback, and as a charity we continue to strive to share our information as a far as we can and work towards preventing such experiences as yours. Take care of yourself x