Placental Abruption in Early Pregnancy

My coworker, who is 13 weeks pregnant, was diagnosed with a placental abruption. They put her on bed rest and told her that it will correct itself or she will miscarry. Can you explain more about her condition?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

A placental abruption is a blood clot behind the placenta. It could reabsorb or it could cause a miscarriage. If your friend is having bleeding from an abruption this early, it doesn't look very good. The placenta is barely functioning at this point, and much of the passing of nutrients is just beginning. This bodes well for the baby but not for the attachment of the placenta. A clot must reabsorb and could leave behind scar tissue. Most often the placenta accommodates this by growing larger in other areas.

The reason behind such a premature separation is of concern as well. I would take a history, which would include such things as hypertension, drug use, trauma, domestic violence, smoking, uterine infection, IUD use, sexually transmitted disease and uterine myomas. Sometimes, these things can scar the lining of the uterus and cause faulty placental attachment.

We don't really know if bedrest will help this situation. She should be followed by serial ultrasounds to watch the clot and observe fetal growth. If the bleeding stops and the fetus is growing appropriately, I would anticipate a normal pregnancy. If, on the other hand, infection starts, the clot enlarges or there seems to be inadequate growth, this would probably mean a pregnancy loss.

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