What Causes Placental Abruption?
Placental abruption can happen suddenly and, unfortunately, cannot be prevented. However, doctors are responsible for providing mothers with sound medical advice should any risk factors present. More than that, doctors must diagnose placental abruptions as soon as the signs and symptoms become apparent.
If the abruption is not treated swiftly, it can lead to heavy vaginal bleeding. In worst cases, placental abruption can even cause fetal and maternal death.
Did your doctor fail to diagnose placental abruption even with signs and symptoms present? Was treatment not delivered within a reasonable amount of time? Both failure to diagnose and treat placental abruption may count as medical malpractice.
The personal injury lawyers at Rosenfeld Injury Lawyers, LLC have helped families recover millions as compensation for medical malpractice. You and your child deserve the best quality of medical care, and if your medical team has failed to give you that, you deserve adequate compensation.
Contact our birth injury lawyers at (888) 424-5757 (toll-free phone number) or use the contact form today to schedule a free case evaluation. Let our medical negligence attorneys hold the physicians financially and legally responsible through the legal process.
What Is Placental Abruption?
The placenta is an organ that forms in the uterus during pregnancy. It provides oxygen and nutrients to the fetus and removes waste products from the fetus’s blood. The placenta forms around 7 to 10 days after conception, then at around seven weeks of pregnancy, the umbilical cord grows from it.
Placental abruption (abruptio placentae) occurs when the placenta separates from the uterus wall either wholly or partially before the baby is born. The placenta has many blood vessels that transfer nutrients and oxygen to the baby. When the placenta separates from the uterine wall prematurely, these blood vessels bleed.
When left untreated, abruption can lead to pregnancy complications, such as severe bleeding, blood clotting issues, kidney failure, and shock due to blood loss. For the child, placental abruption can cause slowed growth, lack of oxygen (which can, in turn, lead to brain damage), preterm birth, and even fetal death.
Possible Symptoms of Placental Abruption
Usually, placental abruption happens in the third trimester of pregnancy. Recognizing the symptoms of abruption is crucial in preventing severe complications.
Signs and symptoms of placental abruption include the following:
- Vaginal bleeding
- Back pain
- Abdominal pain
- Uterine contractions
- Uterine tenderness or hardness
- Decreased fetal movement
The most common symptom of placental abruption is vaginal bleeding, although it may not always be present. Note that the amount of vaginal bleeding does not indicate the severity of placental abruption.
In some cases, the blood becomes trapped in the uterus, which would not cause vaginal bleeding even with severe placental abruption. Vaginal bleeding may also be intermittent when placental abruption develops slowly.
Other Causes of Vaginal Bleeding During Pregnancy
In some cases, bleeding may not point to an abruption but placenta previa.
Placenta previa is a condition where the placenta is attached near the cervix (the opening of the uterus) or covering the cervix. When the uterus thins in preparation for labor, the placenta covering the cervix will bleed, resulting in severe blood loss.
Aside from placenta previa, bleeding can also be caused by a subchorionic hemorrhage, when blood accumulates between the placenta and the uterus.
In any case, it’s essential to seek medical attention as soon as you experience any of the symptoms mentioned above. Your doctor must determine the cause of your bleeding, be it placenta previa, subchorionic hemorrhage, or suspected placental abruption.
Why Placental Abruption Occurs
Possible causes of placental abruption include abdominal trauma, and rapid loss of the amniotic fluid (the fluid that surrounds the fetus in the uterus) can also lead to placental abruption.
The exact cause of placental abruption is typically unknown in most cases. However, certain risk factors contribute to the risk.
Risk Factors of Placental Abruption
Here are the risk factors that can make you more at risk for placental abruption:
Advanced Maternal Age
Mothers 35 or older are more at risk of placental abruption, among other pregnancy complications.
Carrying more than one fetus increases the risk of placental abruption.
If you have experienced placental abruption in previous pregnancies, there is a 10% chance of it happening again.
High Blood Pressure
Hypertension or high blood pressure increases the risk of bleeding between the placenta and uterine wall. A condition called preeclampsia is a common cause of hypertension during pregnancy.
The more pregnancies you’ve had, the more susceptible you are to placental abruption.
Excessive Amniotic Fluid
Having more amniotic fluid in the placenta can lead to a higher risk of bleeding.
Thrombophilia is a blood clotting disorder wherein the blood clots too quickly.
Premature Rupture of Membranes
Your water breaking before 37 weeks of pregnancy can lead to placental abruption.
Smoking and Drugs
Smoking and using recreational drugs (primarily cocaine) are commonly linked to a higher risk of complications during pregnancy, including placental abruption.
Previous Cesarean Delivery
Cesarean delivery in a prior pregnancy is also a risk factor for this condition.
Short Umbilical Cord
An umbilical cord that is abnormally short can increase the risk of abruption. An ultrasound during the first trimester of pregnancy can diagnose this condition.
Potential Complications of Placental Abruption
Abruption can cause severe conditions for both the mother and child.
For the mother, placental abruption can cause:
- Kidney failure
- Blood clotting issues
- Emergency hysterectomy (removal of the uterus)
- Maternal death due to severe blood loss
For the child, placental abruption can cause:
- Brain damage due to decreased oxygen
- Retarded growth due to poor blood flow
- Premature birth
How Is Placental Abruption Diagnosed?
The symptoms of placental abruption can be similar to other complications in pregnancy, such as placenta previa and preeclampsia. To come up with an accurate diagnosis, your provider may need the following information:
- Medical history
- Physical examination
- Blood tests
- Internal analysis of the vagina and cervix
- Ultrasound to examine the placenta
- Fetal monitoring to assess the baby’s heart rate
There are three grades of placental abruption:
- Grade I: Small amount of bleeding, no signs of fetal distress, some contractions
- Grade II: Mild to moderate bleeding, some contractions, signs of fetal stress
- Grade III: Moderate to severe bleeding, abdominal pain, uterine contractions that do not rest, low blood pressure of the mother, fetal death
Sometimes, the premature separation of the placenta from the uterus wall is not discovered until after the baby is born. In this case, the doctor will find clotted blood behind the placenta.
How Is Placental Abruption Treated?
It is impossible to prevent placental abruption. There is also no way to reattach the placenta once it separates from the uterine wall. If you experience placental abruption, your doctor will recommend treatment based on the following factors:
- The severity of the placental abruption
- The gestational age of your baby
- Signs of distress from your baby
- The amount of blood you’ve lost
Mild Placental Abruption
Mild abruption at 24 to 34 weeks of pregnancy requires close monitoring at the hospital. There is no way to stop placental abruption, but your doctor must run tests to assess your and your baby’s condition.
If you and your unborn baby are doing well, you may be given treatment to prevent early delivery for as long as possible. Your doctor may also provide medications to accelerate your baby’s lung development.
In some cases, your doctor may want you to stay in the hospital until you give birth, depending on the gestational age of your baby. Vaginal delivery is also possible if the bleeding is mild and the baby’s heart rate is stable.
You may also be able to go home if the bleeding stops. If the bleeding is heavy, you may need a blood transfusion.
Moderate to Severe Placental Abruption
Moderate to severe abruption usually calls for immediate delivery. If you need to give birth right away, your chances of having a vaginal birth are smaller.
If you lose a lot of blood, you may also be given a blood transfusion. If you experience uncontrolled bleeding, you may need an emergency hysterectomy (removal of the uterus) to save your life.
How to Reduce Your Risk of Abruption
There is no way to prevent conditions like placenta previa and placental abruption. Nevertheless, you can reduce your risk by following these suggestions:
- Go to your provider immediately if you experience vaginal bleeding, primarily when it occurs beyond 37 weeks of pregnancy. It would help if you ruled out placenta previa and other complications to get proper treatment.
- Do not smoke or use drugs. These habits can cause abruption and a long list of other conditions.
- Maintain a healthy blood pressure by monitoring your diet and talking to your doctor about hypertension problems.
- Take safety precautions like wearing a seatbelt and avoiding risky activities like running, especially in your third trimester.
- Talk to your doctor about complications from a previous pregnancy, including placenta previa, gestational diabetes, and preeclampsia. If you have experienced abruption in a previous pregnancy, there are 1 in 10 chances of it reoccurring.
If the treatment is swift, babies born after an abruption might experience no long-lasting effects. The consequences are also affected by the severity of the abruption. For example, if the baby was deprived of oxygen for too long before being born, it may suffer brain damage.
On the other hand, mothers may have a higher chance of experiencing abruption again. The risk of different pregnancy and labor complications increases, primarily if the abruption occurs during the third trimester.
Placental Abruption Birth Injury Lawyers
Placental abruption is unpreventable but treatable. Medical providers are responsible for diagnosing and treating placental abruption as quickly as possible to prevent severe and long-term complications.
If you feel that your provider did not perform their duty to prevent this condition within reasonable expectations, they may be liable for medical malpractice.
At Rosenfeld Injury Lawyers LLC, our personal injury attorneys have litigated placental abruption cases where a child or mother was injured due to an undetected or poorly addressed placental abruption during labor and delivery.
Call a placental abruption lawyer at (888) 424-5757 (toll-free phone number) or use the contact form to schedule a free consultation and discuss your legal situation. All confidential or sensitive information you share with your placental abruption lawyer remains private through an attorney-client relationship.
We offer every client a "No Win/No-Fee" Guarantee, meaning if we cannot secure monetary compensation on your behalf, you owe us nothing. In addition, all information you share with our law office will stay confidential.