Placental Abruption During Pregnancy: Signs and Treatment

The placenta delivers nutrients to a developing baby — but rarely, complications like placental abruption happen. Early diagnosis and treatment reduces risks for both mom and baby.

woman experiencing placental abruption during pregnancy
Julien L. Balmer/Stocksy

Some vaginal spotting during pregnancy can be disconcerting — but fortunately in many cases, it’s nothing to worry about. However if you experience vaginal bleeding accompanied by abdominal pain, it could be a sign of placental abruption — a more serious but treatable condition, especially if it's caught early. Here’s what you need to know about placental abruption, from symptoms to diagnosis and treatment.

What is placental abruption?

Placental abruption (also called abruptio placentae) is the early separation of the placenta (the fetal support system, which provides baby with nutrients and oxygen from you via the umbilical cord) from the uterine wall during pregnancy, rather than after delivery.

How common is it?

Placental abruption is relatively rare, with slight separation occurring in only about one of 150 pregnancies (that’s less than 1 percent). More severe separation happens in only about one out of 800 to 1,600 deliveries. It almost always occurs in the second half of the pregnancy, most often in the third trimester.

Who’s most at risk?

Placental abruption can happen to anyone, but it occurs most frequently in women who:

What are the signs and symptoms?

The symptoms of abruptio placentae depend on the severity of the detachment but usually include:

What you need to know

If the placenta separation is slight, there is usually little danger to the mother or baby as long as treatment is prompt and proper precautions are taken.

If the abruption is more severe, however, the risk to the baby is considerably higher. That's because a placenta's complete detachment from the uterine wall means that the baby is no longer getting oxygen or nutrition.

When to call your doctor

Let your practitioner know immediately if you have abdominal pain accompanied by bleeding, especially in the second half of your pregnancy. Same goes if you fall on your abdomen or are in a car accident. Placental abruption can be treated to protect both you and your baby — but delayed diagnosis and treatment can be dangerous for both of you.

How placental abruption is diagnosed

A diagnosis is usually made using patient history, physical exam and observation of uterine contractions and fetal response to them. Tests for placental abruption may include, among others:

Treatment for placental abruption

Treatment depends on the severity of the separation:

Slight separation

If your placenta has separated from the uterine wall but has not completely detached and your baby's vital signs stay regular, you may be held in the hospital for observation and released if the condition doesn’t worsen and bleeding stops. You’ll also probably be put on bed rest (more commonly known these days as activity restriction).

If the bleeding continues, you may require intravenous fluids. Your practitioner may also administer steroids to speed up your baby's lung maturation in case you need to deliver early.

Severe separation

If the abruption is severe or if it continues to progress, the only way to treat it is to deliver the baby — otherwise the fetus may not be getting nutrients and oxygen and the mother may experience significant, though rarely life-threatening, blood loss or postpartum hemorrhaging (in which case a blood transfusion is usually required). The decision as to whether to do a vaginal or cesarean delivery will depend on your condition and that of your baby.

Updated 8/31/15

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