“Oh no… something is wrong.” When these words
suddenly enter your mind or spill out of your mouth, there is
usually good reason to worry – especially when you’re
Severe complications during a pregnancy can arise without warning.
In some instances, the problem may not be evident until it is
discovered through routine blood tests or imaging. But in other
cases, the trouble is immediately apparent. With placental
abruptions, it’s often the latter.
Vaginal bleeding, intense abdominal or back pain, and unexpected
uterine contractions, tenderness or rigidity are all potential
signs of a placental abruption that are clearly evident to an
expectant woman. Usually, one or more of these symptoms will prompt
a visit to the doctor’s office or hospital. Once a diagnosis
has been made, the medical team will determine how to proceed based
on the severity of the abruption, the stage of the pregnancy, and
the risk to the fetus and woman.
Although many pregnancies with placental abruptions will still
conclude with the labour and delivery of healthy babies, some will
result in premature births, still births, and birth injuries such
as cerebral palsy caused by a lack of oxygen and nutrients getting
to the fetus.
When one of these tragic outcomes occur, it’s only natural to
ask: “Could something have been done?”
In this blog post I’ll explain how placental abruptions occur,
list some risk factors, outline potential treatments, and discuss
why some cases of placental abruptions may be candidates for a
birth injury lawsuit.
The placenta and abruptions
The placenta is a temporary fetal organ that develops soon after
conception. When this flat, oval-shaped organ implants itself in
the uterus, it creates a critical link between the fetus and
Maternal and fetal blood are brought into very close contact in
the placenta (but not mixed) as a way for the mother’s body to
supply oxygen and nutrients to the developing baby and to remove
waste. The placenta (also known as afterbirth because it is
expelled from the uterus after delivery) is connected to the fetus
by the umbilical cord.
Until a newborn baby can breathe on its own, feed, and expel
waste through urine and feces, the placenta (with the umbilical
cord) is a literal fetal lifeline.
In about one percent of all pregnancies, the placenta separates
from the uterine wall lining prior to birth. In most cases this
abruption is partial. With proper medical monitoring and treatment,
the developing baby can still receive adequate oxygen and nutrients
to assist in its growth.
However, if the separation is moderate to severe or a complete
abruption, it is a medical emergency. As the fetus and mother may
both be at risk, an emergency C-section will be performed. If there
was severe bleeding from the abruption the mother may require a
blood transfusion or other blood products. In rare cases, if
bleeding cannot be stopped, an emergency hysterectomy may be
What are Placental Abruption Risk Factors?
Often the cause of a placental abruption remains unknown.
However, certain conditions appear to put some pregnancies at
higher risk. These include:
· a previous non-trauma related placental abruption
· trauma to the abdomen
· multi-fetus pregnancies
· high blood pressure
· blood clotting disorders
· maternal infection
· illicit substance abuse, particularly cocaine
· excess amniotic fluid
· premature rupture of the membranes and rapid loss of
· advanced maternal age (over 40)
· low PAPP-A (pregnancy associated plasma protein-A) in
the first trimester
· high AFP (alpha-fetoprotein) in the second
· uterine artery waveform notching
Placental Abruption Prevention and treatment
Placental abruptions are generally unpredictable. However, good
prenatal care and monitoring – especially when risk factors
are present – can lead to better outcomes. For example, if a
woman has experienced a previous non-trauma related placental
abruption, her risk of a future abruption during a subsequent
pregnancy increases 15- to 20-fold. Ensuring the doctor is aware of
such risks can help them decide whether more frequent pre-natal
visits or testing are advisable.
If other risk factors can be minimized through maternal
education (smoking and drug use), otherwise treated (maternal
infections) or managed (high blood pressure), the odds that a
pregnancy will experience a placental abruption may decrease.
Many partial abruptions can be identified on ultrasounds, while
abnormal fetal growth or development are additional signs that
there may be a problem with the placenta or umbilical cord that is
limiting nutrient and oxygen delivery to the fetus.
If an abruption does take place, medical practitioners must
follow established standards of care to provide the best chances
for an outcome that protects the fetus and/or the pregnant woman.
This includes timely decision-making about whether it is possible
to prolong the pregnancy or how to deliver the baby to minimize
injury to it and/or the mother.
When does a placenta abruption cause harm?
Unfortunately, despite a doctor’s best efforts, some
placental abruptions will lead to still births, birth injuries,
and/or maternal injury. In the aftermath of such injuries or
deaths, part of the grieving process often involves loved ones
asking: “How could this have happened?”
Frequently, all standards of care were followed, and it is
reasonable to conclude that nothing could have been done to prevent
the harm. In these cases, even if a child has sustained a severe
birth injury, medical providers are not liable for any damages or
compensation to the child or its loved ones.
In some cases, however, there may be reason to believe that an
error made through medical negligence has breached standards of
care and caused harm. For example, if a pregnant woman presented
with obvious signs of a placental abruption at a hospital or
doctor’s office, she should receive some form of treatment such
as additional monitoring. If she was sent home without such
intervention and she either miscarried or later delivered a child
with a birth injury such as cerebral palsy or birth asphyxia, the
medical providers could be liable.
If you or a loved one has experienced a placental abruption that
resulted in harm to you or your child, and you believe substandard
medical treatment may have played a role, it is usually worthwhile
to contact an experienced birth injury lawyer to review the facts
and medical records. A birth injury lawsuit for medical malpractice
can result in a settlement or court award that could significantly
assist you, your child, and your loved ones as you move forward
with your lives. This is especially true if your child requires
significant medical treatment or life-long care.
When the medical malpractice lawyer team at Gluckstein Personal
Injury Lawyers receives a call about a placental abruption injury,
we conduct a preliminary investigation to determine if it is
something actionable. If we believe we can help you collect damages
and compensation after this investigation, we will offer to
represent you as you make a civil claim.
But even if what happened to you cannot be remedied in the
courts, our commitment to full circle client care means we will do
whatever we can to help you find alternative paths to healing,
including connecting you with support groups and assisting with
complaints to medical regulatory colleges or hospital ombuds.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.