Placental Abruption and Birth Injury
Under normal circumstances, the placenta is attached to the uterine wall, providing nutrition, gas exchange and waste removal for the baby. It is expelled after the baby is delivered. In some cases, the placenta separates prematurely from the uterine wall. When this happens, the baby can stop receiving adequate oxygen. A placental abruption is a medical emergency and can become severe very quickly. Any signs of placental abruption may require immediate delivery (often in the form of C-section delivery). If a C-section is delayed, this can cause injury to the child.
The placenta is an organ within the uterus that provides nutrients and oxygen to the baby from the mother. 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. Sometimes, however, the placenta separates prematurely from the inner wall of the uterus.
This is known as placental abruption (or abruptio placentae). It can occur during pregnancy after 20 weeks gestation. However, it often occurs during labor when the trauma of contractions causes the placenta to tear.
If there is a complete 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 should the abruption worsen.
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)
- Intellectual disabilities
- Developmental delays
- Learning Disabilities
- Motor disorders
- Periventricular leukomalacia (PVL)
Causes of Placental Abruption
There are a number of conditions and risk factors associated with placental abruption. They include:
- Maternal hypertension (preeclampsia or high blood pressure). This is the most common cause of placental abruption occurring in about 44% of cases.
- Trauma of contractions during labor
- Sudden decompression of the uterus from events such as the delivery of the first child in a multiples birth or premature rupture of membranes (mother’s water breaking too soon)
- Accidental puncture of the placenta from a needle (e.g. amniocentesis)
- Chorioamnionitis (an infection of the two membranes of the placenta — the chorion and the amnion – and the amniotic fluid.)
- Abnormal uterine blood vessels
- Previous placental abruption
- Mother over the age of 35 or younger than 20
- 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.
Symptoms and Diagnosis of Placental Abruption
There are a few signs and symptoms of placental abruption:
- Placental abruption progression
- Bleeding during the second half of pregnancy or excessive bleeding during labor
- Intense abdominal pain
- Uterine contractions during labor that last longer than normal
- Uterus that becomes hard to the touch during labor
- Fetal distress
In cases where the placental abruption causes fetal distress or non-reassuring fetal heart tones on the fetal monitor, the baby must be delivered by an emergency “crash” C-section. The baby should be delivered in less than 18 minutes in order to avoid permanent brain damage from hypoxic ischemic encephalopathy (birth asphyxia).
Award-Winning Birth Injury and Placental Abruption Attorneys Helping Children Since 1997
Reiter & Walsh, P.C. 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 represent clients and their families in all 50 states of the U.S. We’re equipped to handle these cases in Michigan, Ohio, Tennessee, Texas, Arkansas, Mississippi, Washington, D.C., Pennsylvania, Wisconsin, and other states. The Reiter & Walsh, P.C. birth trauma team has also handled FTCA cases involving military medical malpractice and federally funded clinics.
If you or a loved one were permanently injured from a preventable placental abruption, we urge you to reach out to our team.
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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.
Related Articles and Blogs from ABC Law Centers
- “Placental abruption requires quick action by medical staff.”
- “Emergency C-sections: when 30 minutes isn’t fast enough.”
- “Hospitals sued, settle for millions in recent cases of infant brain damage and death caused by failure to diagnose placental abruption.”
- Tikkanen M, Luukkaala T, Gissler M, et al. Decreasing perinatal mortality in placental abruption. Acta Obstet Gynecol Scand 2013; 92:298.
- Ananth CV, VanderWeele TJ. Placental abruption and perinatal mortality with preterm delivery as a mediator: disentangling direct and indirect effects. Am J Epidemiol 2011; 174:99.
- Aliyu MH, Salihu HM, Lynch O, et al. Placental abruption, offspring sex, and birth outcomes in a large cohort of mothers. J Matern Fetal Neonatal Med 2012; 25:248.
- Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand 2011; 90:140.
- Pariente G, Wiznitzer A, Sergienko R, et al. Placental abruption: critical analysis of risk factors and perinatal outcomes. J Matern Fetal Neonatal Med 2011; 24:698.
- Ananth CV, Oyelese Y, Yeo L, et al. Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants. Am J Obstet Gynecol 2005; 192:191.
- Ananth CV, Getahun D, Peltier MR, Smulian JC. Placental abruption in term and preterm gestations: evidence for heterogeneity in clinical pathways. Obstet Gynecol 2006; 107:785.