What Is Placental Abruption?

Photo by Anastasiia Chepinska on Unsplash

Written by Hannah Simpson, BSN, RN 

Understanding placental abruption

Placental abruption is a condition that can occur during pregnancy. When a woman is pregnant, she grows an organ known as a placenta. The placenta is a temporary organ, and it is located inside the mother’s uterus. It develops throughout pregnancy and is delivered shortly after the delivery of the baby. The purpose of the placenta is to provide oxygen and nutrients to the developing baby and to remove waste products. In a normal pregnancy, the placenta does not detach from the uterus until delivery. However, in placental abruption, the placenta separates from the uterus before delivery (1). 

This can be a dangerous situation because there is a risk that the mother will have severe bleeding if the placenta detaches before it is supposed to. Not only is this potentially harmful to the mother, but it also can harm the baby because the mother’s blood is what carries oxygen to the baby. If the mother experiences severe bleeding, the baby may be impacted by not receiving enough oxygen. 

There are two different types of placental abruption: partial and complete. As the name suggests, in a partial placental abruption the placenta does not completely detach from the uterus. Only a part of it detaches. In a complete placental abruption, the placenta detaches entirely from the uterus. 

You may also hear placental abruption called abruptio placentae. Both terms refer to the same condition. 

Risk factors 

Placental abruption is a rare pregnancy complication. However, there are certain factors that are known to increase a woman’s risk of placental abruption. These risk factors include having a placental abruption during a previous pregnancy, smoking, cocaine use, maternal age above 35, and high blood pressure (2). 

During pregnancy, there are certain assessment findings that are associated with a greater risk of placental abruption. These risk factors include being pregnant with twins or triplets, preeclampsia, excess amniotic fluid around the baby, and a short umbilical cord (2). 

Lastly, experiencing abdominal trauma during pregnancy is known to increase the risk of placental abruption. This kind of trauma can result from accidents such as a car accident or a fall. A physical assault during pregnancy can also increase the risk of a placental abruption. 

Symptoms 

For the mother, symptoms of placental abruption include vaginal bleeding, cramping, abdominal pain or tenderness, and back pain. Sometimes there may not be visible bleeding with a placental abruption. This is because blood can become trapped behind the placenta. When this happens, it is known as a concealed placental abruption. For the baby, the heart rate monitor may show irregular patterns during placental abruption (3). 

Diagnosis 

The healthcare provider team will use several tools to diagnose a placental abruption. These diagnostic tools include a review of the mother’s symptoms, a physical exam, ultrasounds, blood pressure monitoring, and monitoring the baby’s heart rate. 

Treatment 

The treatment for placental abruption will depend on the circumstances. Some of the factors that will influence the plan of care include the severity of mother’s bleeding, at what point of the pregnancy the placental abruption is occurring, and the gestational age of the baby. 

A mild placental abruption may be treated with rest and monitoring (1). A severe placental abruption requires immediate delivery, possibly by performing a cesarean section delivery. Depending on the severity of the bleeding, the mother may need fluids and possibly a blood transfusion. 

Conclusion 

Placental abruption is a condition that happens during pregnancy when the placenta detaches from the uterus before the baby has been delivered. It may partially detach or completely detach. The treatment plan for placental abruption will depend on the severity of the abruption and the gestational age of the baby. Always consult a healthcare provider for concerns regarding the care and treatment of placental abruption. 

References 

1. Cleveland Clinic [Internet].Placental Abruption. Available from: https://my.clevelandclinic.org/health/diseases/9435-placental-abruption

2. Sullivan M, Skelly CL, Rouse C. Placental Abruption. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482335/ PubMed PMID: 29493960.

3. Brandt J, Ananth C. Placental abruption at near-term and term gestations: pathophysiology, epidemiology, diagnosis, and managementAmerican Journal of Obstetrics & Gynecology, 2023; 228, S1313-S1329

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