Articles and Topics
What does placental abruption mean?
Andy Oakwood
Unfortunately, the diagnosis of placental abruption may now place your wife in a higher risk group than before. Placental abruption means that a portion of the placenta has pulled away from its original attachment against the uterine wall. The majority of the placenta must stay attached to the uterus in order to provide adequate blood flow, oxygen, and nourishment for the baby. (Normally the placenta does not separate from the uterus until after the baby is born.) A very tiny abruption may be of no serious consequence, while a very large abruption can be life-threatening for the baby.

Abruptions may be caused by major trauma or accidents, use of certain drugs (cocaine is classic), vigorous contractions, and is more common in women over 35 years old, women with diabetes or high blood pressure, women with multiple gestations (twins, triplets), women who have already had more than four children, women with previous abruptions and women who smoke. To optimize your chances for a healthy outcome, your wife should avoid vigorous physical activity, and activities that lead to uterine contractions (such as exercise and sexual relations). Smoking and drug use are, of course, forbidden.

To monitor this pregnancy, your doctor may prescribe a series of ultrasound exams which may help to visualize the extent of the abruption by measuring a blood clot that forms between the placenta and uterine wall. This may stabilize and even reduce in size during the pregnancy. Your doctor may also order “non-stress tests”, which monitor the baby’s heart beat pattern to detect whether the baby is under stress. If your wife experiences painful contractions, severe abdominal pain or vaginal bleeding, she should immediately go to the hospital for care. If an abruption is severe and the baby is in distress, an immediate delivery may be necessary to save the baby’s life and to prevent excessive blood loss from the mother.
Laura E. Stachel M.D. Obstetrician & Gynecologist