Placental Abruption

Placental abruption is the premature separation of the placenta from the uterus. This can cause pain and complications for the mother and the child. The mother can suffer bleeding, hypotension, and kidney failure. The baby can suffer fetal distress, low birth weight, or stillbirth. When a mother shows signs of placental abruption, doctors should take action to reduce the risk of injury to the mother and child.  

What is Placental Abruption?

The placenta is a temporary organ that attaches to the uterine wall and provides protection to the developing fetus. The placenta helps provide nutrients to the child from the mother through the umbilical cord. The umbilical cord transfers nutrients and oxygen and carries away waste products and carbon dioxide. 

After giving birth, the uterus continues to contract, which moves the placenta forward. The placenta will continue to move, through pushing or pressing on the stomach until the placenta is delivered, usually within about 5 minutes of birth. In a cesarean birth, the doctor will remove the placenta after delivering the baby, and then close up the incision. 

Placental abruption occurs when the placenta begins to separate before giving birth. This pregnancy complication can put the mother and baby at risk of injury or death. Placental abruption can occur at any time but is more common around the end of the second trimester or beginning of the third trimester. Placental abruption occurs in about 1% of all pregnancies. Abruptions may range from small and minor to significant abruptions that require emergency surgery. 

With a placental abruption, the child is at risk of not getting enough oxygen or nutrients from the mother. Bleeding at the site of the abruption can also put the baby and mother at risk of harm due to hemorrhage. Placental abruption may cause vaginal bleeding but abruption caused by venous bleeding at the outside of the placenta may be trapped in behind the placenta so the patient does not experience bleeding.

Signs and Symptoms of Placental Abruption

The signs and symptoms of placental abruption may occur suddenly but in the early stages, there may be no significant symptoms. The symptoms may depend on the extent of the abruption and where bleeding occurs. Common signs and symptoms of placental abruption include: 

  • Sudden abdominal pain
  • Sudden back pain
  • Discomfort
  • Tenderness
  • Contractions that do not stop
  • Vaginal bleeding
  • Decreased fetal movement
  • Decreased fetal heart rate
  • Fetal heart rate abnormalities

Risks and Causes of Placental Abruption

The causes of placental abruption are not always clear. However, some patients are at higher risk of placental abruption. Risk factors that increase the chances of a placental abruption include: 

  • Over the age 35
  • Pregnant with multiple babies
  • Traumatic injury, like a car accident
  • History of high blood pressure 
  • Previous abruption during pregnancy
  • Uterine infection
  • Umbilical cord problems
  • Thrombophilia
  • Pre-eclampsia
  • High amounts of amniotic fluid 
  • Smoking
  • Cocaine use

If a doctor suspects placental abruption, a physical exam and imaging may be used to diagnose the condition. A rising fundus may indicate bleeding in the placenta. An ultrasound can help rule out other conditions and complications. Fetal monitoring will also show whether the fetus is in distress and the fetal heart rate. 

Placental Abruption Injuries to Mother and Baby

The risk of injury to the mother and baby may depend on the severity of the placental abruption. In mild cases, the mother's blood pressure and heart rate do not change significantly and there is no fetal distress. 

In moderate cases, the mother may experience an increased heart rate and changes in blood pressure. The fetus may go into distress, which puts the baby at risk of hypoxia or oxygen deprivation. If the baby is deprived of oxygen for too long, brain cells begin to die and the child may suffer permanent brain damage. 

With severe placental abruption, there may be heavy bleeding causing the mother to go into shock. Hemorrhagic shock occurs when there is a significant loss of blood and the body tries to route the remaining blood supply to important organs like the brain and heart. If the hemorrhage is not treated, it can lead to brain injury, coma, or death. 

When the mother's blood supply is compromised due to bleeding, the baby is also at risk of hypoxic injury. A low blood and oxygen supply in the mother will cause low oxygen supply to the fetus. Without adequate oxygen, the fetus may suffer severe brain damage or fetal death.  

Treatment of Placental Abruption

Treatment for placental abruption depends on the severity of the condition and at what point in the pregnancy the abruption occurs. With a minor abruption, bed rest may help the mother and child avoid risk of injury. A mild abruption generally involves minor blood loss where the mother and baby are in a stable condition. If the abruption occurs at an early stage, before 36 weeks, the doctor may administer corticosteroids to improve the baby's lung development. 

If the mother is near full term, the doctor may induce labor or perform a cesarean section to deliver the child. If the abruption is severe, it may require immediate delivery, generally as an emergency cesarean section. If the bleeding continues after delivery, a hysterectomy may be required to remove the uterus. 

The prognosis for a mother and baby after placental abruption depend on a number of factors, including the gestational age of the baby, amount of blood lost, and lack of oxygen supply to the baby. 

Placental Abruption and Medical Malpractice

Doctors are held to a standard of care. When doctors breach that standard of care, causing injury to the patient, the doctor may have committed medical malpractice. Medical malpractice during pregnancy and labor can be devastating because it can put the mother and baby at risk of injury. 

Babies and young children have developing brains that are very sensitive to damage when they do not get enough blood and oxygen to function. If a doctor, hospital, or medical staff do not respond properly to placental abruption, it can put the baby at risk of permanent brain damage, leaving the child facing possible:

Medical errors related to placental abruption may involve failure to diagnose placental abruption, delayed treatment of a mother and child with placental abruption, delayed delivery for a baby with fetal distress, failure to monitor the mother and baby, and failure to continue to monitor the mother after delivery. 

Placental Abruption Birth Injury Attorneys

If a medical mistake involving placental abruption caused a birth injury in your child, talk to an experienced medical malpractice attorney about holding the doctors and healthcare systems accountable for their actions. Do not hesitate to contact Gilman & Bedigian today for a free consultation.

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