Recurrent placental abruption: what to know

Placental abruption happens when the placenta separates from the uterine wall before birth. It can cause vaginal bleeding, abdominal or back pain, uterine tenderness, contractions, or reduced fetal movement, although visible bleeding may be absent. A prior abruption is relevant history in a later pregnancy and should be discussed at the first appointment.

Your maternity team may review blood pressure, bleeding history, placental position, growth, and fetal wellbeing. Conditions such as high blood pressure, abdominal trauma, smoking, or clotting problems may influence the plan, but a recurrence cannot be ruled in or out by home monitoring.

Arrange pre-pregnancy or early pregnancy counselling and bring records from the earlier birth if available. Ask when monitoring should begin, how blood pressure will be followed, and which symptoms require immediate assessment. Take prescribed medicines as directed and discuss smoking cessation, trauma prevention, and any bleeding promptly.

If abruption is suspected, hospital assessment may include maternal observations, blood tests, fetal monitoring, and ultrasound. Delivery timing and method depend on bleeding, maternal stability, gestation, and fetal condition; a Caesarean section may be recommended in some emergencies.

Call emergency services or go to a maternity unit immediately for vaginal bleeding, constant or severe abdominal or back pain, a hard or tender uterus, regular contractions, dizziness, fainting, or reduced fetal movement. Do not wait for bleeding to become heavy, because abruption can occur without obvious blood loss.

How will my previous abruption change antenatal monitoring? Which blood pressure or bleeding symptoms need same-day review? If abruption is suspected, where should I go, and what factors would affect the timing or mode of birth?