Placental Abruption

INFORMATION FOR WOMEN WHO HAVE PLACENTAL ABRUPTION DURING PREGNANCY

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is placental abruption during pregnancy?

Also known by its Latin term, abruptio placentae, placental abruption is a situation characterized by the placenta detaching, partly or entirely, from the uterus, too early, meaning before the baby is born. This is a severe emergency because it means that the supply of blood is cut off for the fetus, plus the mother will bleed.

How common is placental abruption during pregnancy?

Placental abruption occurs in approximately 0.4 to 1.0 percent of pregnancies, but not all cases are severe enough to cause fetal death. Factors elevating the risk of abruption include smoking, use of cocaine, physical abuse, older maternal age (age 35+), high blood pressure (including as part of preeclampsia), and history of placental abruption in a previous pregnancy.

How is placental abruption during pregnancy diagnosed?

Dark red vaginal bleeding with pain occurring suddenly in the third trimester, with a tender uterus, strongly suggests placental abruption. Still, a definitive diagnosis can be made only after birth with a direct examination of the placenta itself.

Does placental abruption cause problems during pregnancy?

Placental abruption causes hemorrhage, often to the point that a blood transfusion is needed, and sometimes a need for an emergency hysterectomy. Other complications include disseminated intravascular coagulopathy (DIC, a severe clotting and bleeding complication) and kidney failure. Also, any time there is a lot of blood loss, this can lead to a life-threatening state called hypovolemic shock.

Does placental abruption cause problems for the baby?

Placental abruption accounts for approximately 10 percent of preterm deliveries and can lead to low birth weight, asphyxia (deprivation of oxygen), fetal death, stillbirth, and neonatal death. 10 to 20 percent of perinatal deaths are the result of placental abruption.

What to consider about taking medications when you are pregnant or breastfeeding:

  • The risks to yourself and your baby if you do not treat the placental abruption
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat placental abruption during pregnancy?

Depending on how close you are to term, you will be given corticosteroid medications, such as betamethasone or dexamethasone, to accelerate the maturation of the fetal lungs to enable early delivery.

Who should NOT stop taking medication for placental abruption during pregnancy?

If the fetal lungs are not mature enough for the fetus to be viable, then refusing corticosteroids poses an increased risk to the fetus.

What should I know about choosing a medication for my placental abruption during pregnancy?

It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.

You may find Pregistrys expert reports about the medications to treat this condition in www.pregistry.com/expertreports. Additional information can also be found in the sources listed below.

What should I know about taking a medication for my placental abruption when I am breastfeeding?

Placental abruption is a complication that can occur only during pregnancy since the placenta and baby are out and disconnected from the uterus by the time that you are breastfeeding.

What alternative therapies besides medications can I use to treat my placental abruption during pregnancy?

The best treatment for the condition is generally delivery as soon as possible. In addition to caesarian delivery, other surgical procedures, such as hysterectomy, may be needed after delivery, or you may need a cesarean-hysterectomy (the baby and uterus are removed in the same procedure). Along the way, you also likely will need blood transfusions, which means that packed red blood cells, fluid, and sometimes other blood products will be infused.

What can I do for myself and my baby when I have placental abruption during pregnancy?

Follow the instructions of your physicians. Be assured that the babys life depends greatly on how well your condition can be managed.

Resources for placental abruption in pregnancy:

For more information about placental abruption during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:

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Last Updated: 03-01-2020
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.