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Placenta abruptio

Premature placental separation; Placental separation; Placental abruption; Vaginal bleeding - abruption; Pregnancy - abruption

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Anatomy of a normal placenta
Placenta
Placenta
Ultrasound, normal placenta - Braxton Hicks
Ultrasound, normal fetus - arms and legs
Ultrasound, normal relaxed placenta
Ultrasound, color - normal umbilical cord
Placenta

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What is Placenta Abruptio?

The placenta connects the fetus (unborn baby) to the mother's uterus. It allows the baby to get nutrients, blood, and oxygen from the mother. It also helps the baby get rid of waste.

Placenta abruptio (also called placental abruption) is when the placenta separates from the inner wall of the uterus before the baby is born.

More About This Condition

In most pregnancies, the placenta stays attached to the upper part of the uterine wall.

In a small number of pregnancies, the placenta detaches (pulls itself from the wall of the uterus) too early. Most of the time, only part of the placenta pulls away. Other times it pulls away completely. If this happens, it is most often in the 3rd trimester.

The placenta is the lifeline of a fetus. Serious problems occur if it detaches. The baby gets less oxygen and fewer nutrients. Some babies become growth restricted (very small), and in a small number of cases, it is fatal. It can also cause significant blood loss for the mother.

What Causes It?

No one knows what causes placental abruption. But these factors raise a woman's risk for it:

Signs of Placental Abruption

The most common symptoms are vaginal bleeding and painful contractions. The amount of bleeding depends on how much of the placenta has detached. Sometimes the blood that collects when the placenta detaches stays between the placenta and uterine wall, so you may not have bleeding from your vagina.

If you have any of these symptoms during your pregnancy, tell your health care provider right away.

How is Placental Abruption Treated?

Your provider will:

If your placental abruption is small, your provider may put you on bed rest to stop your bleeding. After a few days, most women can go back to their normal activities in most cases.

For a moderate separation, you will likely need to stay in the hospital. In the hospital:

Severe placental abruption is an emergency. You will need to deliver right away, most often by C-section. It is very rare, but a baby can be stillborn if there is a severe abruption.

Can I Prevent Placental Abruption?

You cannot prevent placental abruption, but you can control the risk factors related to it by:

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Hull AD, Resnik R, Silver RM. Placenta previa and accreta, vasa previa, subchorionic hemorrhage, and abruptio placentae. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

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Review Date: 10/5/2020  

Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 10

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