Premature placental abruption: what to know

The placenta supplies oxygen and nutrients to the baby through the womb wall. If it separates too early, bleeding can occur behind the placenta or through the vagina, and the womb may become painful, firm or continuously tender. The amount of visible bleeding does not always show how much bleeding is present internally.

Clinicians assess your circulation, pain, vaginal bleeding, uterine activity and the baby’s heartbeat. Blood tests, monitoring and ultrasound may be used, although an ultrasound does not always show the separation.

Call emergency services or go to an emergency maternity unit immediately for vaginal bleeding, sudden abdominal or back pain, a hard tender womb, contractions, dizziness or reduced fetal movement. Lie on your side while waiting, keep phone access available, and do not drive yourself if you feel faint or unwell.

Hospital care may include fluids, blood tests, continuous fetal monitoring and preparation for birth if continuing the pregnancy is unsafe. In some situations birth is by [Caesarean Section](/treatments/pregnancy-and-birth-care/caesarean-section/).

This condition requires emergency assessment rather than a routine appointment. Treat any bleeding or persistent abdominal pain in pregnancy as urgent, especially when paired with reduced fetal movement, weakness, faintness or regular tightenings. Contact maternity services even if bleeding is light or pain improves.

Once you are safe, ask what the monitoring shows, whether the baby needs urgent birth, how your blood count and clotting are being followed, and what recovery and follow-up will involve.