Placental abruption

The placenta is your baby’s support system in the womb. If your placenta doesn’t work properly, your baby is at risk of health problems.

plancental abruption diagram

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
  • contractions
  • 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.

Read about the research that Tommy’s carries out into the placenta

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.

Read more about the health risks of premature birth according to gestational age

Sources

  1. BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/basics/epidemiology.html
  2. BMJ Best Practice (accessed Sept 2016http://bestpractice.bmj.com/best-practice/monograph/1117/basics/aetiology.html
  3. BMJ Best Practice (accessed Sept 2016http://bestpractice.bmj.com/best-practice/monograph/1117.html
  4. J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
  5. RCOG (2011) Antepartum Haemorrhage, Green-top guideline 63,  Royal College of Obstetricians and Gynaecologists
  6. BMJ Best Practice (accessed Sept 2016http://bestpractice.bmj.com/best-practice/monograph/1117/diagnosis/history-and-examination.html
  7. BMJ Best Practice (accessed Sept 2016http://bestpractice.bmj.com/best-practice/monograph/1117/treatment/step-by-step.html
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Last reviewed on September 1st, 2016. Next review date September 1st, 2019.

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Comments

  • 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

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