Under normal circumstances, the placenta is attached to the uterine wall, providing nutrients, oxygen, and waste removal for the baby. It is usually expelled naturally after the baby is delivered as part of the “afterbirth.”
Placental abruption happens when the placenta separates prematurely from the uterine wall. It usually occurs in the third trimester, but can occur as early as 20 weeks gestation. Placental abruption occurs in about 1% of pregnancies (1).
When this happens, the baby can stop receiving adequate oxygen. A placental abruption is a medical emergency and can become severe very quickly (2). Any signs of placental abruption may require immediate delivery via C-section. If a C-section is delayed, this can cause brain injury to the child.
During a normal pregnancy, the placenta remains attached to the walls of the uterus until the baby is born. Once the baby is delivered, the placenta will naturally separate and will be expelled from the birth canal. In placental abruption, the placenta separates prematurely from the inner wall of the uterus.
It can occur during pregnancy after 20 weeks of gestation (1). However, it usually occurs during labor, when the trauma of contractions causes the placenta to tear.
If there is a significant placental abruption, the baby will stop receiving oxygen from the mother. When this occurs, the baby must be delivered right away, usually by emergency C-section. A partial placental abruption can turn severe very quickly, so delivery should occur right away if the baby is at or near term. If the baby is premature, the physician will usually closely monitor the mother and baby and be prepared for a fast C-section delivery should the baby become distressed or the abruption worsen.
Causes of placental abruption
There are a number of conditions and risk factors associated with placental abruption. They include (1):
- Maternal hypertension (preeclampsia or high blood pressure).
- Trauma to the abdomen (through an accident or fall)
- Premature rupture of membranes (mother’s water breaking too soon) (2)
- Chorioamnionitis (an infection of the two membranes of the placenta – the chorion and the amnion – and the amniotic fluid) (2)
- Pregnant with multiples
- Previous placental abruption
- Advanced maternal age (over 35)
- Abnormalities in the uterus
- Rupture of membranes
- Induction of labor
Signs and symptoms of placental abruption
Signs and symptoms of placental abruption can include (1):
- Vaginal bleeding (20% of women will not experience bleeding)
- Rapid contractions or uterine irritability
- Uterine pain or tenderness
- Abdominal pain
- Fetal heart rate abnormalities
- Back pain (2)
Any amount of bleeding during pregnancy should be documented and assessed by your medical caregiver as soon as possible. Excessive bleeding requires immediate emergency medical attention.
Any trauma to the abdomen during pregnancy should be assessed immediately!
Diagnosis of placental abruption
Caregivers should suspect and act on placental abruption based on risk factors and symptoms described above.
Treatment for placental abruption
A patient with a partial separation must be closely monitored and and delivered emergently if the condition becomes non-reassuring (1).
Complications of placental abruption
Placental abruption can lead to the following (1, 2):
- Fetus not getting enough oxygen*
- Fetal death
*Failure to quickly deliver a baby when a placental abruption occurs can cause the baby to experience severe oxygen deprivation (birth asphyxia), which can cause the following conditions:
- Hypoxic-ischemic encephalopathy (HIE): HIE usually involves damage to the basal ganglia, cerebral cortex or watershed regions of the brain, but it sometimes includes periventricular leukomalacia (PVL)
- Neonatal encephalopathy
- Permanent brain damage
- Seizure disorders
- Cerebral palsy (CP)
- Developmental delays
- Learning disabilities
- Motor disorders
- Periventricular leukomalacia (PVL)
Award-winning birth injury and placental abruption attorneys helping children since 1997
ABC Law Centers was established specifically to handle birth trauma cases, and our attorneys have over 100 years of joint experience in the field of birth trauma litigation. Birth injury cases are often long, complex and emotionally demanding. Beyond our focus on delivering unparalleled legal services, our attorneys and staff work to build close, comforting, and openly communicative relationships with clients. At every step of the litigation process, our small, family-oriented team is there to support you and keep you informed. Although we’re based in Detroit, Michigan, we’re equipped to handle these cases in Michigan, Ohio, Tennessee, Texas, Arkansas, Mississippi, Washington, D.C., Pennsylvania, Wisconsin, and other states. The ABC Law Centers birth trauma team has also handled FTCA cases involving military medical malpractice and federally-funded clinics.
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If your loved one was permanently injured from a preventable or improperly managed placental abruption, we urge you to reach out to our team. We don’t charge any legal fees unless we win your case!
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Video: placental abruption & hypoxic ischemic encephalopathy (HIE)
Watch a video of Jesse Reiter discussing how a prompt C-section delivery can prevent a baby from experiencing prolonged birth asphyxia and resultant hypoxic-ischemic encephalopathy when obstetrical emergencies – such as a placental abruption – occur.
- Placental Abruption: Risks, Causes, Symptoms and Treatment. (2017, May 02). Retrieved February 18, 2019, from http://americanpregnancy.org/pregnancy-complications/placental-abruption/
- Placental abruption. (2018, January 12). Retrieved February 18, 2019, from https://www.mayoclinic.org/diseases-conditions/placental-abruption/symptoms-causes/syc-20376458