Placental abruption, a condition when the placenta separates from the womb (uterus) during a pregnancy, is a medical emergency. In most cases, this condition is well-managed and there are no long-term problems. However, in some cases, a placental abruption is not recognised or treated quickly enough, leading to serious injury to the baby and sometimes also to the mother.In this blog, I explain what placental abruption is, what the signs are, and how it can affect babies and parents when something is missed.What is a placental abruption?During pregnancy, the placenta is your baby's lifeline. It attaches to the wall of the womb and connects to your baby via the umbilical cord, providing vital oxygen and nutrients to the baby and removing carbon dioxide and other waste products from the baby.Once your baby is born, the placenta is delivered too - this is known as the third stage of labour.A placental abruption happens when the placenta separates too early from the womb before your baby is born. This means your baby may not be getting enough oxygen or nutrients in those critical final hours or minutes. It's a serious complication, and when it's not recognised or acted on quickly, it can be life-threatening.There are different types of abruptions. An abruption may be partial, where only part of the placenta has detached from the womb or it may be complete, where the entire placenta has become detached. In addition, an abruption may be:Revealed: where there's clear vaginal bleeding.Concealed: where the bleeding is hidden, and pools behind the placenta. This can be hard to spot.orAsymptomatic: in rare cases, there are no symptoms, and it's only discovered after birth.Concealed abruptions are particularly dangerous because the signs can be mistaken for typical labour or pregnancy pain. That's why prompt, accurate diagnosis is so important.What causes placental abruption?Sometimes there's no clear reason for a placental abruption, but there are known risk factors including:Smoking during pregnancy (which can double the risk)Infections or other problems in the uterusA previous placental abruptionPre-eclampsia (high blood pressure during pregnancy)Low levels of amniotic fluidHaving a multiple birth (i.e. twins or triplets)Trauma, like a fall or car accidentEven without risk factors, an abruption can still happen. What matters most are a quick diagnosis and prompt treatment.What are the signs?Placental abruption usually happens later in pregnancy, but it can occur at any time. Signs and symptoms include:Vaginal bleedingAbdominal pain and cramping (the level of pain can vary)Uterine tenderness, including a tense or hard bumpLower back painChanges in your baby's heart rate or movementsSpeak to your midwife, GP, or local maternity unit straight away if you think you have symptoms of a placental abruption. If you are unable to contact them, call 111 for advice. Call 999 if you have severe bleeding or pain that is making you feel very unwell.Medical professionals treating you should listen to your concerns and examine you, monitor the foetal heart, perform an ultrasound scan and/or do blood tests. Sometimes medical professionals may fail to recognise the link between your symptoms and a placental abruption, or they may reassure you that your symptoms are not serious.If they don't listen to you or take your concerns seriously or fail to monitor the foetal heart and perform the necessary tests, they may miss a chance to intervene and protect you and your baby.Treatment - what should happenIf a placental abruption is caught early and acted on quickly, many babies are born safely.When there's a known or suspected placental abruption, urgent delivery, often by emergency caesarean section, is the usual response. In some cases, if the pregnancy is in the earlier stages and the abruption is minor, close monitoring may be enough. But it must be genuinely close, with regular scans and checks on your baby's wellbeing and, if necessary, inpatient monitoring so you're in the right place if your baby's condition deteriorates and needs to be delivered quickly.The impact of delayed treatmentIf there's a delay, the consequences can be devastating. If your symptoms and concerns were ignored or dismissed, if the abruption wasn't picked up until was too late, or if it was picked up but delivery was delayed or you were not monitored closely enough, you and your baby may suffer serious harm.Your baby may experience an irreversible brain injury, such as hypoxic-ischaemic encephalopathy, due to oxygen deprivation. My colleague and head of the Child Brain Injury Team, Claudia Hillemand has recently written a blog about this, which you can read here.There is also a risk of the baby being born prematurely, or even stillborn, having been deprived of the oxygen and nutrients it needs. Some mothers also face dangerous blood loss or long-term emotional trauma from what happened. The effects can be lifelong - not just for your child, but for your whole family.How we've helpedThe solicitors in our specialist Child Brain Injury Team act exclusively for children who have sustained brain injuries due to negligence and are experts in helping children who've suffered brain injuries at or around the time of birth.Among the many families we have helped are those whose children have suffered harm because of delays in diagnosis or treatment of placental abruption, including:Premature birth and complicationsCerebral palsyDevelopmental delays and learning difficultiesPhysical disabilitiesBehavioural disordersWe know the sooner your child, your family and you get the help and support you need the brighter the future for you all.Our specialist Child Brain Injury Team at Bolt Burdon Kemp has supported many families whose children have suffered serious, life-changing injuries because a placental abruption wasn't picked up or treated quickly enough. Through a claim for compensation, we can ensure your child gets the best possible chance to thrive.A successful claim can help secure the resources and opportunities your child needs to flourish, including specialist therapies, equipment, adapted housing, educational support, as well as giving you an understanding of what happened. Above all, a successful claim can give you peace of mind for the years ahead, knowing your child, despite their disabilities will be cared for no matter what happens to you.We're here when you're readyIf you believe you or your baby suffered harm because the medical professionals involved in your care didn't listen to you, or didn't take your concerns seriously, or you believe they didn't monitor you or you baby closely enough, or delayed in diagnosing and treating placental abruption, please do get in touch.There's no obligation and no cost for an initial chat. Just honest, expert advice, and a team that genuinely cares about what happens next for you and your child.
