Diagnosis

If your health care provider suspects placental abruption, he or she will do a physical exam to check for uterine tenderness or rigidity. To help identify possible sources of vaginal bleeding, you might need blood tests or an ultrasound.

During an ultrasound, high-frequency sound waves are used to create an image of your uterus on a monitor. It's not always possible to see a placental abruption on an ultrasound, however.

Treatment

It isn't possible to reattach a placenta that's separated from the wall of the uterus. Treatment options for placental abruption depend on the circumstances:

  • The baby isn't close to full term. If the abruption seems mild, your baby's heart rate is normal and it's too soon for the baby to be born — generally before 34 weeks of pregnancy — you might be hospitalized for close monitoring. If the bleeding stops and your baby's condition is stable, you might be able to rest at home. In some cases, you might be given medication to help your baby's lungs mature, in case early delivery becomes necessary.
  • The baby is close to full term. If your baby is almost full term — generally after 34 weeks of pregnancy — and the placental abruption seems minimal, a closely monitored vaginal delivery might be possible. If the abruption progresses or jeopardizes your health or your baby's health, you'll need an immediate delivery — usually by C-section. If you experience severe bleeding, you might need a blood transfusion.

Preparing for your appointment

Placental abruption is often a medical emergency, leaving you no time to prepare. However, it's possible that your health care provider might notice signs of an impending abruption before an emergency situation develops. Depending on the suspected severity of your placental abruption, you might be admitted to the hospital and monitored — or you might be admitted for emergency surgery to deliver the baby.

If you and the baby are being monitored in the hospital, here's some information to help you prepare for what's to come, and what to expect from your doctor.

What you can do

While you're in the hospital:

  • Pay attention to changes. Alert your health care team immediately if there's a change in your symptoms or their frequency.
  • List all medications you've been taking, including vitamins and supplements. Be sure to let your doctor know if you've smoked during your pregnancy or used illegal drugs.
  • Ask a loved one or friend to be with you, if possible. Sometimes it can be difficult to remember all of the information provided, especially in an emergency situation. Someone who's with you might remember something that you missed or forgot.

A loved one can also help you keep track of the questions you have for your doctor to make sure you don't forget to ask something that's important to you. Some basic questions you might want to ask your doctor include:

  • What kinds of tests do I need? How do I prepare for these tests?
  • Is the baby in any danger? Am I in any danger?
  • What are the treatment options?
  • What are the possible complications?
  • What can I expect if the baby is born now?
  • Will I need a blood transfusion?
  • What are the chances that I might need a hysterectomy after the delivery?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. For example:

  • When did you first begin experiencing signs and symptoms?
  • Have you noticed any changes in your signs and symptoms?
  • How much bleeding have you noticed?
  • Can you feel your baby moving?
  • Have you noticed any clear fluid leaking from your vagina?
  • Have you had any nausea, vomiting or lightheadedness?
  • Are you having contractions? If so, how close together are they?
Dec. 13, 2014
References
  1. Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Oct. 23, 2014.
  2. Cunningham FG, et al. Williams Obstetrics. 24th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://accessmedicine.mhmedical.com/book.aspx?bookid=1057. Accessed Oct. 23, 2014.
  3. Ananth CV, et al. Placental abruption: Clinical features and diagnosis. http://www.uptodate.com/home. Accessed Oct. 23, 2014.
  4. Oyelese Y, et al. Placental abruption: Management. http://www.uptodate.com/home. Accessed Oct. 23, 2014.