Placental abruption is a condition during pregnancy when the placenta separates from the uterus. Symptoms can include bleeding and abdominal pain, especially during the third trimester. A healthcare provider will diagnose and treat a placental abruption based on the severity of the separation and gestational age of the fetus.
Placental abruption is a complication of pregnancy that happens when the placenta separates from your uterus before delivery. The placenta is a temporary organ that connects a growing fetus to your uterus during pregnancy. It attaches to the wall of your uterus, usually on the top or side and acts as a lifeline that gives nutrients and oxygen to the fetus through the umbilical cord. The placenta also removes waste from the fetus's blood.
In placental abruption, the placenta may completely detach or partially detach. This can decrease the amount of oxygen and nutrients to the fetus and cause heavy bleeding in the birthing parent. Placental abruption is a serious condition that requires medical treatment.
In placenta previa, the placenta is covering all or part of the birthing parent's cervix. It's also called low-lying placenta. Think of it as an obstacle that’s blocking the exit from the uterus. Even though the placenta is in a complicated position, it’s still attached to the uterus. When the placenta detaches from the uterus, this is a placental abruption. Both conditions can cause vaginal bleeding during pregnancy and labor.
About 1 out of 100 pregnancies has placental abruption. This condition is usually seen in the third trimester, but it can happen any time after 20 weeks of pregnancy up until delivery.
Placental abruption can be life-threatening to the fetus and sometimes to you. Complications from a placental abruption include:
For birthing parent:
The cause of placental abruption is often unknown. Certain lifestyle choices or abdominal trauma can increase your risk for placental abruption.
You are at higher risk for placental abruptions if you have any of the following:
Each person can have different symptoms of placental abruption. However, the most common symptom is vaginal bleeding with cramping during the third trimester of pregnancy. Symptoms or signs can also include:
Vaginal bleeding can vary and is not an indication of how much the placenta has separated. In some instances, there could be no visible bleeding because the blood is trapped between the placenta and the uterine wall. Pain can range from mild cramping to strong contractions and often begins suddenly.
These symptoms can resemble other pregnancy conditions. Always consult with your healthcare provider for a diagnosis.
Most of the time, you will see some blood during a placental abruption. In the event of a concealed abruption, the blood will be behind the placenta. In that case, there will be no bleeding. In other cases, the abruption develops slowly, which can cause occasional, light bleeding.
Talk to your healthcare provider about any vaginal bleeding you experience during your pregnancy.
You may experience sudden or sharp pain, cramping, or tenderness in your lower pelvic region or back during a placental abruption. You could also feel less movement from the fetus. You should discuss these symptoms with your healthcare provider immediately.
The most common symptom of a placental abruption is vaginal bleeding, although you will not always bleed. You may also have sudden, ongoing pain in your abdomen or back.
Placental abruption is diagnosed through an exam and monitoring. You may be admitted to the hospital depending on the severity of the abruption or you may be able to rest at home. Your healthcare provider will:
There are typically three grades of placental abruption a healthcare provider will diagnose:
It is important to discuss any symptoms or changes in symptoms with your healthcare provider.
Once the placenta has separated from the uterus, it cannot be reconnected or repaired. A healthcare provider will recommend treatment based on:
Generally, the severity of the abruption and gestational age of the fetus are the two most important factors:
If the fetus isn't close to full term:
If the fetus is near full term:
Placental abruptions are typically unpreventable. You can reduce your risk by:
This can vary depending on the severity of your symptoms and how far along you are in your pregnancy. You can expect to be monitored closely and often. Watch for any changes in symptoms and discuss them with your healthcare provider immediately.
The two factors that affect survival rate are gestational age at birth and the severity of the abruption. Early detection, close monitoring, and quick treatment can help reduce complications.
You have about a 15% chance of having another abruption in a future pregnancy. With two prior abruptions, this chance increases to about 25%. If you have had a previous abruption, please let your healthcare provider know.
Your healthcare provider should be able to answer your questions and prepare you for treatment of placental abruption. Here are some questions you might ask:
Sexual intercourse is not a direct cause of placental abruption. In most cases, it’s perfectly safe to have sex during pregnancy. Activities with a high risk of falling or abdominal trauma should be avoided during pregnancy.
Sneezing is a normal thing your body does and is not a cause for placental abruption. It can't harm the fetus in any way. If you have any concerns about frequent and forceful sneezing or coughing, reach out to your healthcare provider for guidance.
Smoking can increase your risk of many complications during pregnancy, including placental abruption. Ask your healthcare provider about ways to quit smoking.
Call your healthcare provider immediately if are bleeding, cramping or experience pelvic pain during your pregnancy, especially in the third trimester.
A note from Cleveland Clinic
Placental abruption is an uncommon, yet serious condition people can experience during pregnancy. Talk to your healthcare provider if you experience vaginal bleeding, pelvic pain or cramping. Placental abruption should be diagnosed and treated promptly to ensure you and your baby are healthy.
Last reviewed by a Cleveland Clinic medical professional on 07/07/2021.
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