Placental Abruption and Uterine Rupture: What to Know

Placental abruption occurs when the placenta separates from the uterine wall before birth. Uterine rupture is a tear through the uterine muscle, most often discussed during labour in someone with a previous uterine scar, although it can have other causes. Both can reduce oxygen reaching the baby and cause internal or external bleeding. Their symptoms can overlap: sudden abdominal pain, tenderness, contractions that change, abnormal fetal heart rate, vaginal bleeding, dizziness, or collapse. The absence of visible bleeding does not rule out a serious problem.

Tell the maternity team about the pain's onset, any previous uterine surgery, bleeding, fluid loss, trauma, and changes in fetal movement. The team may assess your pulse and blood pressure, examine your abdomen, monitor the baby's heart rate, and check contractions. Blood tests and ultrasound may support the assessment, but urgent decisions can depend on your symptoms and the baby's condition rather than one test. If the baby or mother is unstable, the team may recommend immediate birth and treatment for bleeding. A Caesarean birth is often considered when rapid delivery is needed.

Call emergency services for sudden severe or constant abdominal pain, vaginal bleeding, faintness, a fast or weak pulse, difficulty breathing, a rigid or very tender abdomen, or reduced fetal movement. During labour, report pain that is unusual for you, contractions that change abruptly, or a baby whose heart-rate monitoring becomes concerning. Do not travel alone when you feel faint or unwell. These symptoms cannot be safely sorted out at home.

Ask which diagnosis the team is considering, what your previous uterine scar means for labour planning, how the baby will be monitored, and what would trigger urgent birth. You can also ask what recovery support is expected after surgery and when to report pain, bleeding, fever, or wound changes.