Diagnosing placental abruption: what to know

Placental abruption happens when the placenta separates from the womb wall before birth. Bleeding may be visible, but it can also remain behind the placenta, so the amount seen does not show how serious the problem is. Clinicians ask about pain, contractions, trauma and baby movements, examine you and monitor the baby’s heart rate. Blood tests can assess blood cells and clotting, while ultrasound may help identify the placenta or another cause, although a normal scan does not exclude abruption.

Go to a maternity unit promptly if abruption is suspected. The team may place an intravenous line, repeat observations and blood tests, and monitor the baby continuously or at intervals based on the situation. They will consider pregnancy stage, bleeding, pain, your condition and the baby’s heart-rate pattern when deciding between observation, continued monitoring or birth. A caesarean section may be needed when urgent birth is safest.

Call emergency services or go to a maternity emergency unit for vaginal bleeding, constant abdominal or back pain, a hard or tender womb, regular contractions, dizziness, fainting or reduced baby movements. After a fall, blow to the abdomen or sudden severe pain, seek help immediately even if there is no visible bleeding.

Ask what the monitoring shows, whether bleeding may be concealed, how your blood tests are changing and what signs would prompt birth. If a caesarean section is discussed, ask why it is recommended, what preparation is needed and how you and the baby will be monitored afterward.