One of the more serious problems that can occur during pregnancy, labor and delivery is placental abruption. This is an obstetric emergency where the placenta separates from the lining of the uterus, depriving the baby of oxygen and nutrients, and potentially causing severe bleeding that can be dangerous to the mother and child. The separation can be minimal or it can be a complete separation. In either case, an emergency C-section is typically performed in order to minimize the risks of birth asphyxia and other birth injuries to the baby.
Image of a Placental Abruption
Who is at risk for placental abruption?
While there is no way to predict a placental abruption, there are some known risk factors:
- A mother with preeclampsia, hypertension (high blood pressure)
- Twin or multiples pregnancy
- Accidental puncture of the placenta (like from an amniocentesis needle), premature water breaking
- Chorioamnionitis (an infection of the two membranes of the placenta -- the chorion and the amnion – and the amniotic fluid.)
- Abnormal blood vessels in the uterus
- Previous placental abruption
- Mother older than 35 or younger than 20
- A male baby
- Elevated maternal serum alpha-fetoprotein in the second trimester
- Other less common causes include cocaine use, uterine fibroids, injury to the uterus (e.g. car accident), alcohol use, and cigarette smoking.
- Excess amniotic fluid (polyhyramnios)
How do doctors diagnose placental abruption?
Blood loss, uterine contractions and fetal distress are the first signs of a potential placental abruption. In cases where placental abruption is suspected, the fetal heart rate will be monitored very carefully and if fetal heart tones are non-reassuring an emergency C-section is done immediately. Additionally, an ultrasound may be done as well as an exam to rule other causes for bleeding.
Placental abruptions occur sometimes during labor from strong uterine contractions. Placental abruption occurs in about one out of every 200 deliveries.
What happens when a placental abruption is diagnosed?
Treatment options for placental abruption depend on the severity of the separation and the baby’s gestational age:
- If the abruption is minor and the baby is premature (before 34 weeks of pregnancy), then delivery may be able to be delayed as long as the mother and baby are doing well and the bleeding is under control. Because there is always the risk that a minor abruption could worsen, the doctors must weigh the risks of prematurity against the danger of the abruption worsening.
- If the baby is nearly full term (after 34 weeks of pregnancy) or if the abruption occurs during labor, an emergency C-section should be done immediately, even if it’s minor because of the risk that the placenta could separate more at any time.
What can happen if a placental abruption is not appropriately diagnosed and treated?
If a placental abruption is not appropriately treated both the mother and the baby are at risk. The mother may experience shock from blood loss, may need blood transfusions, may have clotting issues, and if the bleeding cannot be controlled after birth, may need a hysterectomy.
The risks to the baby include:
- Deprivation of oxygen (birth asphyxia, hypoxic ischemic encephalopathy) leading to cerebral palsy, mental retardation, seizures and other permanent conditions
- Deprivation of nutrients
- Premature birth
What can you do if you suspect your child’s condition is due to improper handling of a placental abruption?
The first step is to get sound legal advice. A qualified attorney can review your medical records and determine if doctors, nurses and other medical staff were negligent in treating your placental abruption. At Reiter & Walsh ABC Law Centers, we work with premiere neurologists, neuroradiologists, obstetricians, labor nurses, child development specialists, therapists, life care planners and more to help determine if a child’s birth injury could have been avoided. We will help you get answers and the compensation your child needs. Contact Reiter & Walsh ABC Law Centers today.