Placental abruption is the early separation of the placenta (afterbirth) from the wall of the uterus (womb). The placenta is an organ that grows inside the uterus during pregnancy to provide food and oxygen to the baby. Separation of the placenta before delivery occurs in about one in 120 births. It can occur any time after about the twentieth week of pregnancy, and occurs more often in the last three months.

Normally the placenta does not separate from the uterus until right after the birth of the baby. When placental abruption occurs, the placenta starts to come away from the uterus before the baby is born. This can cause serious problems for the baby and mother.

You are at a higher risk for placental abruption if you:

The symptoms of placental abruption may include:

How is it diagnosed?

The doctor or midwife will give you a physical exam, looking for signs of blood loss. These tests may be done:

The abruption may be described as a Grade 1 (mild), Grade 2 (mild to moderate), or Grade 3 (moderate to severe).

How is it treated?

This will depend on many things such as:

If the separation of the placenta is small, the baby isn’t in distress, and your condition is stable, you may be able to go home and continue the pregnancy with frequent checkups. You may be advised to avoid sexual activity and some forms of physical activity.

If you are admitted to the hospital, you will be given intravenous (IV) fluids. A fetal monitor will be used to check the baby for signs of distress.  Your blood pressure, pulse, and amount of bleeding will be closely checked. Blood tests will be doneto check your iron level and blood clotting factors.

If the separation is moderate, the baby is not in distress and your condition is stable, the doctor may induce labor and perform a vaginal delivery. If the baby is in distress or if you are losing a lot of blood, the doctor will deliver the baby immediately by cesarean section.

There is no treatment to stop the placenta from separating or to re-attach it. The baby can survive when even up to one half of the placenta is separated from the uterus.

What are the effects?

Sometimes the separation and bleeding begins and then stops without treatment. As long as you and the baby are healthy, your pregnancy can continue with frequent checkups. A mild case will probably have no long-term effects on your health or your baby’s health.

A moderate to severe separation of the placenta may have the following effects:

The good news is that with quick attention and expert care, nearly all mothers and their babies survive.

Helping to prevent placental abruption

Good prenatal care (beginning in the first thirteen weeks and continuing with regular visits) and a healthy diet may reduce the risk of high blood pressure during pregnancy. Prevention of high blood pressure decreases the risk of abruption.

If you smoke, decreasing the number of cigarettes and stopping smoking will decrease your risks of having a placental abruption.

Always use a seat belt in the car to minimize any potential trauma from a car accident.  If an accident does occur, or if you have a fall, either call your provider or go to the hospital for further monitoring. 

Abruption caused by the use of cocaine or amphetamines can be prevented if the mother stops using these drugs.

If you have had a placental abruption with a previous pregnancy and are pregnant again, be sure to report this to your care provider and immediately report any contractions or bleeding you might experience.

If you have further questions about placental abruption, contact your doctor or midwife. This pamphlet is for informational purposes only, and should not replace the advice of a care provider.