Risk factors for placental abruption

Placental abruption happens when the placenta separates from the wall of the uterus before birth. Factors that may raise concern include high blood pressure or pre-eclampsia, a previous placental abruption, abdominal trauma, smoking, cocaine use, and problems affecting blood clotting. Carrying more than one baby and having waters break early can also change the clinical picture. These factors do not predict that separation will happen; they help the maternity team decide how closely to monitor you.

Bleeding may be visible, but separation can sometimes cause mainly abdominal or back pain, a firm or tender uterus, or changes in the baby's movements. The amount of bleeding does not reliably show how serious the separation is.

Tell your midwife or obstetrician about high blood pressure, a previous abruption, bleeding, a fall, or a blow to your abdomen. Attend advised blood-pressure checks and pregnancy appointments, and follow safety advice if you smoke or use recreational drugs. Do not wait for a routine visit if symptoms begin. Assessment may include checking you and the baby, blood tests, and monitoring; treatment depends on the pregnancy stage and findings. If birth is needed, your team may discuss vaginal birth or a Caesarean Section.

Contact maternity emergency services immediately for vaginal bleeding, sudden or persistent abdominal or back pain, a hard or tender abdomen, contractions that feel unusual, dizziness, fainting, or reduced baby movements. Call emergency services if you feel very unwell, collapse, or have heavy bleeding. Keep taking any prescribed blood-pressure medicine unless a clinician tells you otherwise, and do not drive yourself if you are faint or in severe pain.

Ask which of your medical or pregnancy details affect monitoring, what symptoms should bring you straight to hospital, and how blood-pressure control will be checked. You can also ask how the baby's wellbeing will be assessed and what birth plans might change if abruption is suspected.