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Have irregular vaginal bleeding
Stomachache
Tummy/abdominal pain comes in waves of 10 minutes or less
Blood pressure is high
Uterine contractions are coming very frequently
Tachycardia
Stomach continues to be hard
Not seeing your symptoms? No worries!
This is a condition during pregnancy where the placenta separates from the uterus before the fetus is born. Since the placenta is rich in blood supply and provides oxygen and nutrients to the fetus, separation can result in significant vaginal bleeding and cut off oxygen supply to the fetus, endangering both mother and child. Common causes include abdominal trauma in pregnancy such as being in a motor vehicle accident or falling on your abdomen. Other causes are also possible. Symptoms typically include vaginal bleeding and abdominal or pelvic pain similar to contractions. Any such concerns in pregnancy should seek emergency care.
Your doctor may ask these questions to check for this disease:
This requires emergency medical care. There is no treatment to reattach the placenta, but occasionally the abruption may stabilize and allow for continuation of the pregnancy. Depending on the amount of bleeding, The gynecologist/obstetrician may suggest delivering your child early, either through a normal vaginal delivery or a Cesarean section.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Scared of Bleeding? Why Your Placenta is Low-Lying & Medically Approved Next Steps
A.
Low-lying placenta or placenta previa can cause sudden, often painless vaginal bleeding after 20 weeks because the placenta sits near or over the cervix, though many cases found at the mid-pregnancy scan move upward by the third trimester. There are several factors to consider; medically approved next steps often include pelvic rest, activity adjustments, close ultrasound monitoring, and planning a C-section if the cervix remains covered, and any bleeding should be treated as an emergency. For timing, risks, and individualized decisions that can change your plan, see the complete guidance below.
References:
* Jauniaux E, Chantraine F. Placenta Previa: A Comprehensive Review. Semin Perinatol. 2016 Nov;40(6):357-363. doi: 10.1053/j.semperi.2016.09.006. Epub 2016 Sep 27. PMID: 27856230.
* Fan D, Xia Q, Liu L, Wu S, Li X, Liang Z, Chen X, Ao H. Risk Factors for Placenta Previa in the 21st Century: A Systematic Review and Meta-Analysis. J Matern Fetal Neonatal Med. 2017 Apr;30(8):875-880. doi: 10.1080/14767058.2016.1189311. Epub 2016 Jun 1. PMID: 27230588.
* Cresswell JA, Ronsmans C, Calvert C, Filippi V. Placenta Previa: Pathophysiology and Complications. Semin Perinatol. 2016 Nov;40(6):350-356. doi: 10.1053/j.semperi.2016.09.004. Epub 2016 Sep 20. PMID: 27856228.
* Zhang J, Ma Z, Chen P, Li S. Diagnosis of Placenta Previa by Transvaginal Ultrasound: A Systematic Review and Meta-Analysis. Ultrasound Obstet Gynecol. 2020 Feb;55(2):161-169. doi: 10.1002/uog.20842. Epub 2019 Aug 12. PMID: 31338782.
* Vahanian SA, Smulian JC, Ananth CV. Expectant management of placenta previa. Clin Perinatol. 2017 Sep;44(3):477-488. doi: 10.1016/j.clp.2017.06.002. PMID: 28838507.
Q.
Is your placenta healthy? Why it impacts baby and medical next steps.
A.
Placenta health matters because it is your baby’s lifeline for oxygen, nutrients, waste removal, and hormones; when function is reduced by issues like previa, abruption, accreta, or placental insufficiency, risks include bleeding, pain, slowed growth, preterm birth, and rarely stillbirth. There are several factors to consider and your next steps may range from closer monitoring and Doppler or NST testing to hospital care, medications such as steroids, or early delivery; seek urgent care for bleeding, severe pain, or decreased movement, and see below for the full list of warning signs, tests, risk factors, and decision points.
References:
* Burton GJ, Jauniaux E. Placental origins of fetal growth restriction: searching for the perfect compromise. J Anat. 2018 Jan;232(1):32-48. doi: 10.1111/joa.12711. Epub 2017 Aug 10. PMID: 28656686; PMCID: PMC5735165.
* Roberts JM, Redman CW. Preeclampsia: more than a pregnancy disorder. Lancet. 2021 Apr 17;397(10283):1483-1491. doi: 10.1016/S0140-6736(21)00302-4. PMID: 33866997.
* Ernst LM, Perneger TV, Landi-Chablais A, Bernard L, Lecomte D, Wyler M. Placental lesions in stillbirths and their associations with maternal and fetal characteristics: A systematic review. Placenta. 2022 Mar;119:10-21. doi: 10.1016/j.placenta.2021.12.016. Epub 2022 Feb 7. PMID: 35149303.
* Redline RW, Boyd T, Campbell D, Kaplan C, Khong TY, Papaioannou S, Sander CM, Sebire NJ, Timmons BC, Waters BL. The Placental Lesion Classification System (PLAC): a consensus-based approach. Placenta. 2023 Apr;134:110-116. doi: 10.1016/j.placenta.2023.02.001. Epub 2023 Feb 15. PMID: 36796349.
* Stirrat MJ, Reekie BL, Bocking AD, Smith GN, Walker M, Bainbridge SA. Placental Function and the Development of Maternal and Fetal Disease. Physiol Rev. 2024 Jan 1;104(1):21-120. doi: 10.1152/physrev.00004.2022. Epub 2023 Jun 26. PMID: 37367353.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand. 2011 Feb;90(2):140-9. doi: 10.1111/j.1600-0412.2010.01030.x. Epub 2010 Dec 7. PMID: 21241259.
https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0412.2010.01030.xOyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006 Oct;108(4):1005-16. doi: 10.1097/01.AOG.0000239439.04364.9a. PMID: 17012465.
https://journals.lww.com/greenjournal/Abstract/2006/10000/Placental_Abruption.26.aspxACOG Patient FAQ
https://www.acog.org/womens-health/faqs/bleeding-during-pregnancyNIH Stat Pearls
https://www.ncbi.nlm.nih.gov/books/NBK482335/