Placental Abruption

What is a placental abruption?

Placental abruption refers to a premature separation of the placenta from the wall of the uterus, after 20 weeks’ gestation and prior to delivery. Left undetected or untreated, a placental abruption can be life-threatening to both the mother and child.

The placenta is an organ that develops and attaches to the uterine wall during pregnancy to provide oxygen and nutrients from the mother to the fetus through the umbilical cord. It also removes waste from the blood of the fetus. If the placenta detaches from the uterine lining before delivery, whether partially or completely, the fetus may not receive an adequate supply and quality of oxygen and nutrients to survive.

Symptoms of placental abruption may include:

• Vaginal bleeding, antepartum hemorrhage
• Abdominal pain that may feel “bruise-like”
• Severe back pain
• Uterine tenderness, which may feel rigid or hard
• Frequent uterine contractions, or a contraction that does not end
• Painful contractions
• Abnormal fetal heart rate: variable/late decelerations, reduced variability, bradycardia (i.e., abnormally slow heart rate)

The amount of bleeding does not necessarily indicate the severity of abruption because blood can become trapped between the walls of the placenta and uterus.

Diagnosis of placental abruption:

Early diagnosis, prompt management, and timely delivery improve maternal and perinatal outcomes in patients with placental abruption. A total placental abruption generally presents itself by the symptoms listed above; however, an ultrasound and/or blood tests may help to identify the source of bleeding.

Maternal risk factors include:

• Advanced maternal age (40+)
• Pre-eclampsia – high blood pressure in pregnancy
• Hypertension — a history of high blood pressure
• Hydramnios – excess amniotic fluid
• Blood-clotting disorders
• Preterm ruptured membranes
• Multifetal gestation
• Substance abuse, e.g. cigarette smoking and cocaine use
• Injury to the abdomen
• Prior abruption

Complications:

Without appropriate intervention, placental abruption can have dire consequences to both the mother and child. Mothers can lose significant amounts of blood, leading to shock and the need for a blood transfusion. If bleeding cannot be controlled, an emergency hysterectomy may be performed. If no intervention is taken, the excessive bleeding can lead to death.

The health and safety of the baby, however, is more immediately vulnerable in the event of a placental abruption. Thorough fetal heart rate surveillance is imperative. A disruption in oxygen supply can cause temporary or permanent damage to the developing brain of the child. Sustained, unresolved asphyxia will lead to a stillborn.

Placental abruption and cerebral palsy:

If you suffered a placental abruption and your child has a diagnosis of cerebral palsy, it is worth investigating the quality of care you received.

Cerebral palsy is caused by damage to the developing brain before, during, or shortly after delivery. If a placental abruption is mismanaged, it can lead to preventable brain damage causing cerebral palsy.

Patients in BC are barred from access to hospital medical investigations (under Section 51 of the BC Evidence Act), following a traumatic birth and subsequent cerebral palsy diagnosis. However, this obstacle is overcome by hiring a medical malpractice lawyer.

The law firm of Campbell, Renaud Trial Lawyers has the experience and integrity to get to the bottom of your child’s cerebral palsy diagnosis. After a free consultation, our lawyers obtain your medical records for assessment at no financial cost to you and your family.

Please do not hesitate to contact our law firm with any questions or concerns you may have.