One page summary: Placental abruption

In two sentences

Placental abruption means the placenta pulls away from the wall of the uterus before the baby is born. The baby loses part of their oxygen supply and the mother bleeds. ¹

The most important thing to know is that the bleeding can be hidden. Blood can collect behind the placenta with little or nothing appearing externally, so the amount of visible bleeding does not tell you how serious it is. Severe abdominal pain with a hard, tender uterus and an abnormal fetal heart rate can be abruption with no visible blood at all. ¹

The numbers, with their sources

• What happens. The placenta separates from the uterine wall before delivery, interrupting the baby's oxygen supply and causing bleeding ¹
• Why visible bleeding misleads. Blood can be concealed behind the placenta, so the amount seen externally does not reflect the amount lost ¹
• The main associations. High blood pressure and preeclampsia, trauma, smoking and cocaine use, previous abruption, and rapid loss of fluid ¹
• Effect on the baby. Abruption is one of the acute events recognized as capable of causing brain injury from oxygen deprivation around the time of birth ²
• The clotting complication. Severe abruption can trigger a whole-body clotting disturbance, which is why clotting studies are checked and blood products are prepared ³
• Future pregnancies. A previous abruption raises the risk of another, which changes monitoring in a subsequent pregnancy ¹

What to do this week

1. Ask whether the placenta was sent to pathology and request that report separately.
2. Request the fetal monitoring strips and the delivery record.
3. Ask what your blood loss was and what your hemoglobin is now.
4. Ask about intravenous iron if you are exhausted.
5. For the baby, ask for the cord gases and whether cooling was considered.
6. Ask what this means for a future pregnancy.
7. Ask for a debrief appointment.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the obstetrician

• How much of the placenta separated?
• Was there concealed bleeding, and what was my measured blood loss?
• Did I have a clotting problem, and what was given?
• Was the placenta sent to pathology?
• What does this mean for a future pregnancy?

For the neonatal team

• What were the cord gases and Apgar scores?
• How long between the event and delivery?
• Was cooling considered?
• What follow-up does my baby need?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Placental abruption

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.