A placenta that has separated from
the uterine wall (placenta abruptio) cannot be repaired. Until its
severity can be assessed, placenta abruptio is considered a medical emergency.
If you have suspected or diagnosed placenta abruptio, you will need to be
observed in the hospital. Some abruptions can get worse quickly and become
life-threatening for both you and your fetus.
If your blood type
Rh-negative and you have placenta abruptio, you will
Rh immune globulin shot, such as RhoGAM. This is because your fetus could be
Rh-positive. Bleeding from an abruption can mix the Rh-positive blood with
yours. The Rh immune globulin prevents your
immune system from attacking the Rh-positive
Placenta abruptio is usually treated by an
Mild placenta abruptio
If placental separation is
minor, vaginal bleeding is light, and your fetus is not in distress, you may be
observed in the hospital for several hours or several days. For the remainder
of your pregnancy, you'll probably be advised to avoid strenuous activities,
and you and your fetus will need to be monitored regularly.
you are in preterm labor, the separation is minor, and you are far from your
due date, you may be given
tocolytic medicine to stop labor. For more
information, see the topic
Moderate to severe placenta abruptio
separation is moderate to severe, or if it causes a life-threatening condition
disseminated intravascular coagulation (DIC), rapid
delivery is almost always necessary. Although vaginal delivery is sometimes
possible, the need for rapid delivery increases the likelihood of a
cesarean (C-section). In rare cases of heavy bleeding
that won't stop, the uterus is surgically removed (hysterectomy).
Depending how much blood
you have lost and whether you have disseminated intravascular coagulation, you
may need a transfusion of blood or blood-clotting products, such as
How well your baby does after a placental abruption
depends on how prematurely he or she is delivered and how well the placenta was
able to circulate blood oxygen and nutrients to the fetus before delivery.
Following delivery, it may be necessary to remain close to a
health center able to care for premature infants. A sick or premature newborn
can receive the best treatment possible in a neonatal intensive care unit, or
NICU. Care in the NICU can last days or weeks, depending on the baby's level of
maturity, the extent of the baby's problems, and the amount of care needed. For
more information, see the topic
premature infants can be provided by a
neonatologist, a doctor who specializes in the care of
After having one placental
abruption, you have an increased risk of developing another during a future
pregnancy. After two or more, you have a 1-in-4 risk of having another.2 Although there are no specific treatment guidelines for
preventing another placental abruption, you and your health professional can
take some steps to reduce your risk.
- Avoid high-risk factors such as drug use,
cigarette smoking, or untreated high blood pressure (140/90 mm Hg or
- Experts recommend you take 0.4 mg (400 mcg) to 0.8 mg (800 mcg) of folic acid every day.
- See your health
professional regularly throughout your pregnancy.