Placental Abruption: Is This Likely To Recur?

I had a normal pregnancy and delivery with my first baby but had a placental abruption at 26 weeks with my second, giving birth to a little girl weighing less than two pounds. She is now eight months old and doing wonderfully. My blood pressure is normal and I have never used drugs. What are the chances of having another abruption?

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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

If you have or had none of the risk factors for abruption (premature separation of the placenta) such as hypertension, trauma, medications, drugs, smoking, previous instrumentation to the uterus (as with an abortion), D&Cs, etc., then you can feel fairly confident that this was a random event that is unlikely to occur again.

Some researchers have studied and concluded that women with antiphospholipid antibodies or an excess of homocystein are at an increased risk of abruption. This deficiency of a certain amnio acid can be hereditary or may be a problem in the metabolism of folate. Fetuses with certain heart defects may also be at risk of abrupting their placentas. The fact that you have had a previous successful term pregnancy is hopeful.

In your next pregnancy, you will probably be followed with ultrasounds, including color doppler flow studies and testing for AFP levels, which have recently been found to be elevated in women at risk for abruption. It is especially important for you to take folic acid -- 0.8 mg every day for three months prior to and three months following conception.

What a miracle baby you have! I hope your next pregnancy goes well. It is probable that this will not recur.

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