Placental abruption

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, your provider will likely recommend blood and urine tests and ultrasound.

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

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 early for the baby to be born, 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.

  You might be given medication to help your baby's lungs mature and to protect the baby's brain, in case early delivery becomes necessary.

• The baby is close to full term. Generally after 34 weeks of pregnancy, if the placental abruption seems minimal, a closely monitored vaginal delivery might be possible. If the abruption worsens or jeopardizes your or your baby's health, you'll need an immediate delivery — usually by C-section.

For severe bleeding, you might need a blood transfusion.

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 a coming abruption.

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.

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.
• Let your doctor know about all medications you've been taking, including vitamins and supplements. Include whether you've smoked during your pregnancy or used illegal drugs.
• Ask a loved one or friend to be with you, if possible. Someone who's with you can help you remember the information provided, especially in an emergency.

Some questions you might want to ask your doctor include:

• What tests do I need?
• Is the baby in danger? Am I?
• 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 of my needing a hysterectomy after the delivery?

What to expect from your doctor

Your doctor is likely to ask you questions, including:

• When did your signs and symptoms begin?
• Have you noticed changes in your signs and symptoms?
• How much bleeding have you noticed?
• Can you feel your baby moving?
• Have you noticed clear fluid leaking from your vagina?
• Have you had nausea, vomiting or lightheadedness?
• Are you having contractions? If so, how close together are they?