Placental abruption occurs when the placenta, the tube that sends oxygen and nutrients to your baby during pregnancy, detaches from your uterine wall. This is a medical emergency requiring immediate care at a hospital.

The placenta is the tube that connects your baby to your uterus during pregnancy and sends oxygen and nutrition to your baby. Typically, the placenta stays connected to your uterine wall until shortly after you give birth. It then detaches with the afterbirth.

In the case of a placental abruption, the placenta partially or totally disconnects before delivery. This is a medical emergency. Though it’s rare, occurring in only around 1% of pregnancies, it can be a very serious — sometimes even life threatening — event for you or your baby.

Read on for more information about what causes placental abruption and how it’s treated.

A placental abruption occurs when the placenta separates from the wall of your uterus. A placental abruption decreases or stops the flow of oxygen and nutrients to your baby and may cause you to have heavy bleeding. You need immediate medical care at a hospital.

There are four general types of placental abruption:

  • Partial placental abruption: Only part of the placenta has detached. Part of it is still attached to your uterus.
  • Complete placental abruption: The entire placenta has detached from your uterine wall. This type generally involves more serious bleeding.
  • Revealed placental abruption: The abruption is visible on an ultrasound.
  • Hidden placental abruption: The blood from the abruption is hidden, usually between the placenta and your uterine wall.

Doctors may also use a grading system to describe the severity of a placental abruption. The grades are as follows:

  • Grade 0: You do not have any symptoms, but a blood clot is seen during an exam.
  • Grade 1: You’re experiencing light bleeding and may have only mild symptoms. You and your baby are not showing signs of distress.
  • Grade 2: You’re experiencing a mild to moderate amount of bleeding, and your baby is showing signs of distress, such as changes in heart rate.
  • Grade 3: You’re experiencing moderate to severe bleeding, and you and your baby are showing obvious signs of distress, such as low blood pressure, constant uterine contractions, and a very abnormal fetal heart rate.

Symptoms of placental abruption may vary depending on how completely your placenta has separated from your uterus. A placental abruption can be partial or total, and you’ll need medical care in either case.

The most common symptom of placental abruption is bleeding (also called a bloody show). If you experience any bleeding during pregnancy, contact your OB-GYN or another healthcare professional immediately.

Other signs and symptoms of placental abruption may include:

  • cramping
  • abdominal pain
  • back pain
  • contractions
  • changes in your baby’s heart rate

If you experience these symptoms with or without bleeding, alert your healthcare professional and go to the hospital right away. A placental abruption is a medical emergency, and you may need urgent medical care.

Even if you aren’t sure what’s happening, go to the hospital. If you do have an abruption, a hospital is the best place to get the care you need, and you’ll need that care immediately.

Placental abruption is generally diagnosed at the hospital. A doctor will perform a physical exam and check:

  • how much bleeding you’re having
  • how much pain you’re experiencing
  • whether your heart rate is too fast or too slow
  • whether your baby is showing signs of distress, such as changes in heart rate
  • whether you’re showing any signs of shock
  • whether your baby has died

You will have an ultrasound. Most placental abruptions can be seen during an ultrasound, but some may be small, and bleeding may sometimes be hidden.

Your doctor may order blood work and labs to assess blood loss or fetal-maternal blood sharing (the Kleihauer-Betke test).

They will also monitor your baby’s heart rate using a fetal monitor, a type of listening device that is wrapped around your abdomen and constantly records your baby’s heart rate.

If you have a placental abruption, treatment will likely begin immediately, and things may start to happen quickly around you. Depending on how far along you are in your pregnancy and how serious the abruption is, you may be taken directly to a delivery room so your baby can be delivered as soon as possible.

Immediate delivery (likely by cesarean section) is the main treatment if:

  • the placental abruption is severe or complete
  • you are having heavy bleeding
  • your heart rate or other vital signs are unstable
  • you are near full-term
  • you are in labor
  • your baby’s heart rate is too low or can’t be detected

Other treatment options may be used if the abruption is mild or less severe and if you are between 24 and 34 weeks’ gestation. These options include:

  • taking medication to help your baby’s lungs mature
  • taking medication to help your blood clot and slow or stop your bleeding
  • staying in the hospital so you and your baby can be monitored until delivery
  • staying on bed rest at home

In most cases of placental abruption, the cause is unknown. However, some conditions and events may contribute to an abruption, such as:

  • previous placental abruption
  • smoking
  • high blood pressure
  • cocaine use
  • abdominal trauma (from a car crash, physical abuse, a significant fall, etc.)
  • uterine infection
  • pregnancy at over 35 years old
  • physical changes in the placenta or umbilical cord
  • pregnancy with multiples (twins, triplets, etc.)
  • asthma
  • previous cesarean deliveries
  • a family history of placental abruptions

People who have a placental abruption may experience short-term health events and conditions such as:

  • shock due to blood loss (hemorrhagic shock)
  • hysterectomy
  • blood transfusions
  • admission to the hospital, including the intensive care unit
  • death (in rare cases)

In the long term, they may be at greater risk of experiencing a placental abruption during a subsequent pregnancy. Those who have undergone a hysterectomy will not be able to become pregnant again. And, in rare cases, some people may die as a result of blood loss from placental abruption.

For babies, placental abruption increases the risk of stillbirth. Other conditions that may affect children who experience a placental abruption include:

  • neurological complications such as intraventricular hemorrhage (bleeding in the brain)
  • cerebral palsy
  • delayed development (developmental disorders)

The long-term effects on children who experience placental abruption will vary, depending on how prematurely they are delivered. Early delivery and prematurity may cause more complications for these children than the placental abruption itself. But many children have no long-term effects from placental abruption.

Placental abruption occurs when the placenta, the tube that brings oxygen and nutrition to your baby during pregnancy, detaches from your uterine wall. This is a medical emergency and requires immediate care in a hospital setting.

While bleeding does not always occur, it’s typically one of the main symptoms of placental abruption. That’s why it’s so important that you contact your doctor or another healthcare professional if you’re pregnant and experiencing vaginal bleeding.

Treatment may involve delivering your baby early. In rare cases, placental abruption can be a life threatening condition for both a birthing parent and a baby.