Placental Abruption Birth Injury and Complications

Placental abruption is an uncommon and serious condition that can cause pain and bleeding for the mother and oxygen deprivation for the baby. It occurs when the placenta, which carries nutrients and oxygen to the baby, separates from the uterus before the second stage of labor is complete. This can cause premature birth, growth issues in babies, dangerous even life-threatening complications with the mother, and even stillbirth.

Fortunately, from a statistics standpoint, research from Robert Wood Johnson Medical School suggests placental abruption occurs in only about one percent of pregnancies. It most often happens during the third trimester but can happen at any time from 20 weeks of pregnancy until the end of term. There are four major types of placental abruption. Partial placental abruption occurs when the placenta does not entirely separate from the uterine wall. Complete placental abruption occurs when the placenta separates totally from the uterine wall and generally results in significant bleeding.

Revealed placental abruptions have visible vaginal bleeding. Concealed placental abruptions, on the other hand, show little or no visible vaginal bleeding because the blood is trapped between the placenta and uterine wall. According to March of Dimes, placental abruption is a factor in roughly 10 percent of premature births, which take place before the 37th week of gestation. Preterm babies may have difficulty breathing and lack reflexes for sucking or swallowing and may therefore need to spend additional time in special neonatal care units or intermediate care nurseries for monitoring since their symptoms are not fully developed. Premature infants may also have metabolic, circulatory, and gastrointestinal problems. Although these problems could be temporary, some premature babies suffer long-term challenges like learning difficulties, vision and hearing problems, and cerebral palsy. Premature babies are also more likely to suffer from behavioral or psychological problems and chronic health issues such as asthma and infections. Some may require long-term hospital care.

Unfortunately, premature babies are also more at risk for sudden death syndrome. There can be other more direct effects on babies due to placental abruption. These babies are more likely to experience growth issues even if carried to full term. They can also suffer brain injuries because of oxygen deprivation. Placental abruption sometimes even results in stillbirth, which is the birth of a baby who has died in the womb after at least 20 weeks of pregnancy. There is also a risk to the pregnant mother. Blood loss can result in mothers contracting anemia and facing life-threatening complications such as hemorrhaging, blood clotting, and kidney failure. An article published in StatPearls states that women who suffer placental abruption are also at greater risk for Sheehan syndrome, a rare blood disorder in which the pituitary gland fails to produce one or more hormones. Unfortunately, the exact cause of placental abruption is unknown. Although scientists are unsure of the exact cause, they’ve identified several risk factors that increase the chances of a placental abruption.

In most cases, placental abruption is unpreventable. However, some of the risk factors are controllable. Smoking, a family history of placental abruption, cocaine use during pregnancy, the mother being over 35 years old, hypertension and related problems in the pregnancy, a fall or blow to the abdomen during the pregnancy, early membrane rupture during the pregnancy, an infection in the uterus, asthma, carrying multiple babies, exposure to air pollution, or water breaks before 37 weeks. Early detection and monitoring can affect the outcomes of the placental abruption. There are symptoms or signs of placental abruption to watch for. Vaginal bleeding, abdominal pain or back pain, tenderness, quick contractions in the uterus, problems with the baby’s heart rate, a low amount of amniotic fluid, and baby growth is less than expected.

Treatment depends on the seriousness of the abruption, how far along the pregnancy is, and the amount of distress for the fetus. You may just need rest and monitoring. In more severe cases, you may need to give birth early or via C-section, or you could have complications. If you have a mild abruption at 24–34 weeks, your doctor will likely recommend a hospital visit for close monitoring. You might receive medication to prolong your pregnancy, and it’s possible you may need to stay in the hospital until you give birth. However, if you have a mild abruption at or near full term, your doctor may recommend inducing labor or performing a C-section, especially if the baby’s heart rate indicates problems or the abruption causes significant pain, heavy bleeding, and signs of anemia.

A moderate to severe placental abruption is considered a medical emergency. You’ll likely need to give birth immediately, and the chances of needing a C-section are increased. If you lose a lot of blood, you could need a transfusion. In a worst-case scenario, uncontrollable heavy bleeding may require a hysterectomy, which removes the uterus entirely and prevents having children in the future. The more you know about placental abruptions, the better prepared you can be. Keep in mind that you’re not alone.

You can learn more about causes, treatments, family forums, parent support groups, and more at BirthingCenter.org. The Birth Injury Center is here to assist you, offering consultations and abundant resources available to help you learn more for your own peace of mind. Please visit BirthingCenter.org.