This occurs when the placenta dislodges itself from
the wall of the uterus prematurely, causing the mother
to bleed. Usually it happens close to term or during
labor. It is dangerous for both the mother and baby
as the blood loss is sudden and plenty and at the
same time painful. Sometimes there is an internal
hemorrhage; the bleeding happens inside but you will
look pale and feel faint and shaky. There are no known
reasons but this condition has been associated with
• Preeclampsia, chronic hypertension or gestational
• Intrauterine growth restriction
• Having more than 5 pregnancies
• Had an abruption previously
• Have blood clotting disorders
• Have over-distended uterus
• Have polyhyramnios
• Carrying multiples
• Preterm premature rupture of membranes
Placental abruption may also be a direct result of
an abdominal injury, e.g. you fall onto your stomach,
or you are involved in a major accident.
As mentioned sometimes because the bleeding is internal,
you may not see any blood initially but you will feel
weak. The bleeding follows soon enough but there are
some obvious changes that need immediate medical attention.
So if you experience any of the below signs, don't
delay and call your doctor right away:
• You feel weak, faint, pale, sweaty, disoriented
or your heart beats real fast
• Cramping with or without back ache
• Abdominal pain, tenderness in the abdomen
• Frequent contractions or a prolonged contraction
• A decrease in fetal movement
• Vaginal bleeding that is dark red
In some cases the problem goes away with time and
your pregnancy can continue as normal. In other situations
the birth must be induced and cesarean becomes imminent.
Placenta Praevia or low-lying
In such situations, the placenta lies low in your
uterus. The placenta may cover the cervix totally
(total praevia) or partially (marginal praevia). An
ultrasound is able to capture this image; in a large
number of cases the placenta will move out of the
way before the birth. If the placenta is low-lying
but does not cover the uterus, it will shift positions
when the uterus changes shape at around week 28. Usually
a scan will be arranged between week 30 and 36 to
determine the position. Here again the cause is not
known but your risk increases if:
• You had it in your previous pregnancy
• You had previous c-section(s) - your risk
increases with each operation
• You had other uterine surgeries such as D&C
or fibroids removal
• You are carrying twins or more
• Your age
• You have had many babies
If the placenta is found to be lying low after week
36, you may be admitted to the hospital until you
deliver or you have the option of staying at home
but you will have to make extra visits to the doctor.
A vaginal or cesarean delivery will depend on how
much the cervix is covered. Most doctors would prefer
the 'wait and see approach' so that baby matures up
while others would prefer to induce labor early. Either
way you have to take things easy. Avoid lifting and
carrying heavy items as there is a risk of heavy bleeding.
• The placenta is literally your baby's support
• It starts off as the chorion, a membrane that
surrounds the amnion and develops into a specially
designed organ which interfaces between you and your
• Throughout fetal development, this organ will
provide support and nourishment to your baby.
• It is attached to the embryo by the umbilical
• Apart from this, the placenta also takes over
in the production of some of the key hormones that
was initially manufactured by the ovaries.
• At about 10 weeks after fertilization, the
placenta is fully formed and functioning.
• Between weeks 12 and 20, this organ weighs
more than the baby.
• The placenta also ensures that the mother's
blood and the baby's blood don't mix, and makes sure
the waste products are carried away.
• It acts as a barrier against general infection
by providing antibodies to the baby that it receives
from the mother.
• At term it will weigh about 500gms and measure
at 3cm in thickness and 20-25 cm across. It stays
firmly attached to the uterine wall, usually the upper