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Bleeding can happen at any time during pregnancy. Placental abruption can cause bleeding late in pregnancy. This means after about 20 weeks. Placental abruption is when the placenta pulls away from where it's attached to the uterus. The placenta has many blood vessels that bring the nutrients from the mother to the developing baby. If the placenta starts to pull away during pregnancy, these blood vessels bleed. The larger the area that pulls away, the greater the amount of bleeding.
A direct blow to the uterus can cause placental abruption. For instance, this could happen during a car crash. Healthcare providers don’t know what causes it in other cases. You may be at higher risk if:
The most common symptom of placental abruption is painful, dark red bleeding from the vagina. It happens during the third trimester of pregnancy. It also can occur during labor. Some women may not have vaginal bleeding that can be seen, but there may be bleeding inside the uterus. Symptoms of placental abruption may include:
These symptoms may be caused by other health conditions. Always see your healthcare provider for a diagnosis.
Your healthcare provider can diagnose placental abruption based on your symptoms. These include the amount of bleeding and pain. You will likely need an ultrasound. This test will show where the bleeding is. The provider will also check on your developing baby. There are 3 grades of placental abruption:
Sometimes placental abruption isn't found until after delivery, when an area of clotted blood is found behind the placenta.
There is no treatment to stop placental abruption or reattach the placenta. Your care depends on how much bleeding you have, how far along your pregnancy is, and how healthy your developing baby is. You may be able to have a vaginal delivery. Or you may need a cesarean section delivery if you have severe bleeding or if you or your baby are in danger. You may need a blood transfusion if you lose a lot of blood.
Placental abruption is dangerous because of the risk of uncontrolled bleeding (hemorrhage). This can mean less oxygen and nutrients going to the developing baby. Severe placental abruption is rare. Other complications may include:
Call your healthcare provider about any bleeding you have while pregnant. Bleeding during pregnancy may not be serious. If the bleeding is medium to severe, or you have pain, contact your healthcare provider right away. Key points about placental abruption
Tips to help you get the most from a visit to your healthcare provider:
Medical Reviewer: Irina Burd MD PhD Medical Reviewer: Donna Freeborn PhD CNM FNP Medical Reviewer: Heather M Trevino BSN RNC © 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. Bleeding may occur at various times in pregnancy. Although bleeding is alarming, it may or may not be a serious complication. The time of bleeding in the pregnancy, the amount, and whether or not there is pain may vary depending on the cause.
Placenta previa is a condition in which the placenta is attached close to or covering the cervix (opening of the uterus). Placenta previa occurs in about one in every 200 live births. There are three types of placenta previa:
The cause of placenta previa is unknown, but it is associated with certain conditions including the following:
The greatest risk of placenta previa is bleeding (or hemorrhage). Bleeding often occurs as the lower part of the uterus thins during the third trimester of pregnancy in preparation for labor. This causes the area of the placenta over the cervix to bleed. The more of the placenta that covers the cervical os (the opening of the cervix), the greater the risk for bleeding. Other risks include the following:
The most common symptom of placenta previa is vaginal bleeding that is bright red and not associated with abdominal tenderness or pain, especially in the third trimester of pregnancy. However, each woman may exhibit different symptoms of the condition or symptoms may resemble other conditions or medical problems. Always consult your doctor for a diagnosis. In addition to a complete medical history and physical examination, an ultrasound (a test using sound waves to create a picture of internal structures) may be used to diagnose placenta previa. An ultrasound can show the location of the placenta and how much is covering the cervix. A vaginal ultrasound may be more accurate in diagnosis. Although ultrasound may show a low-lying placenta in early pregnancy, only a few women will develop true placenta previa. It is common for the placenta to move upwards and away from the cervix as the uterus grows, called placental migration. Specific treatment for placenta previa will be determined by your doctor based on:
There is no treatment to change the position of the placenta. Once placenta previa is diagnosed, additional ultrasound examinations are often performed to track its location. Bed rest or hospital admission may be necessary. It may be necessary to deliver the baby, depending on the amount of bleeding, the gestational age, and condition of the fetus. Cesarean delivery is necessary for most cases of placenta previa. Severe blood loss may require a blood transfusion. Placental abruption is the premature separation of a placenta from its implantation in the uterus. Within the placenta are many blood vessels that allow the transfer of nutrients to the fetus from the mother. If the placenta begins to detach during pregnancy, there is bleeding from these vessels. The larger the area that detaches, the greater the amount of bleeding. Placental abruption occurs about once in every 100 births. It is also called abruptio placenta. Other than direct trauma to the uterus such as in a motor vehicle accident, the cause of placental abruption is unknown. It is, however, associated with certain conditions, including the following:
Placental abruption is dangerous because of the risk of uncontrolled bleeding (hemorrhage). Although severe placental abruption is rare, other complications may include the following:
The most common symptom of placental abruption is dark red vaginal bleeding with pain during the third trimester of pregnancy. It also can occur during labor. However, each woman may experience symptoms differently. Some women may not have vaginal bleeding that is detectable, but there may be bleeding inside the uterus. Symptoms may include:
The symptoms of placental abruption may resemble other medical conditions. Always consult your doctor for a diagnosis. The diagnosis of placental abruption is usually made by the symptoms, and the amount of bleeding and pain. Ultrasound may also be used to show the location of the bleeding and to check the fetus. There are three grades of placental abruption, including the following:
Sometimes placental abruption is not diagnosed until after delivery, when an area of clotted blood is found behind the placenta. Specific treatment for placental abruption will be determined by your doctor based on:
There is no treatment to stop placental abruption or reattach the placenta. Once placental abruption is diagnosed, a woman's care depends on the amount of bleeding, the gestational age, and condition of the fetus. Vaginal delivery may be possible if the fetus is tolerating labor. If placental abruption is affecting the fetus, then cesarean delivery may be necessary. Severe blood loss may require a blood transfusion. |