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Any experience with/expertise on Placental Abruption?

(26 Posts)
ISeeIt Sat 14-May-16 12:14:27

I'll try not to ramble too much, but have been awake 72hrs and am not as clear headed as I'd like.

I'm pretty shit at pregnancy - moving swiftly from hyperemesis through SPD and reflux. This is my 4th pregnancy, 3rd (God, hopefully!) baby. I've had two lovely home births though, and just for context on my pain threshold haven't needed pain relief (not that I think for a second that makes me special or super, but might be relevant).

This pregnancy has been pretty rubbish. Hospitalised with HG at the beginning, have suffered norovirus, anaemia, hand foot and mouth and a second d and v bug just this week. It wasn't really severe (like the previous noro was) and died down by Thursday morning. However, breathlessness kicked in Thursday avo, just lying down, and braxton Hicks and lower back pain that persisted throughout the night and were so bad I just couldn't sleep at all. My midwife popped in yesterday morning by which point I was v wobbly, extremely high pulse but normal BP and still having BH. So breathless I freaked out and had a panic attack, so she sent me into hosp to rule out pulmonary embolism. Also concern re placental abruption, since by fundal height my bump doesn't appear to have grown for at least three weeks (measuring at 30cm - I'm 35+3 weeks).

Was in hosp all yesterday, doing lots of waiting for blood tests mostly in a and e. A midwife did a fetal trace when I arrived, which looked fine (my baby was moving MORE than normal if anything, not less), but did show contractions. Then after many hours waiting, an obstetrician popped down, did a speculum (but didn't swab), didn't measure bump and didn't order scan, said she didn't know what might be wrong and said I could leave - although she conceded I look terrible (v pale and purple around eyes). I was fine with this - fed up of hosp and 2 DC at home to look after and suspected I was just done in from the bug. However, the lower back pain and contractions kicked in again from about 9pm and kept me up all night again. The contractions seem endless - my bump will tighten and back feel sore for many minutes before there's any relief, but even in between my bump feels hard iyswim. My bump has been very tender to the touch for about 3 weeks id guess. I'd been wondering now for a while before the pain etc whether I was carrying v differently this time because bump just feels like tight bowling ball, always v hard.

My question is about placental abruption. I always thought this was accompanied by a massive bleed, but upon a little reading have discovered that 20% of cases have no bleeding or fetal distress. But is it likely the back pain and BH would come and go if it were placental abruption? As I say, the tightness is always there but I'm in nowhere near the pain I was last night and the night before.

Any advice would be appreciated. I really don't want to go into hospital unnecessarily but obviously don't want to mess about if there's a real risk.

ISeeIt Sat 14-May-16 12:41:18

Bump for active traffic

Alb1 Sat 14-May-16 16:09:55

Sorry no help with placental abruption but I'd deffiently advise to contact the midwife again. I had a similar thing with my bump being permanently hard and very tender to touch and I wish I'd have got more help now and pushed for an answer rather than just risking it. In my situation it turned out I had far too much fluid in my bump as my baby was unwell, I don't think that's what's going on with you as that's very rare and I had a whole different story, but it never occurred to me that that's what the problem was so who knows if the midwife will spot something in your symptoms that you've never heard of

ISeeIt Sat 14-May-16 17:42:22

Thanks for replying. Been in bed resting and the back pain and contractions have died down. I just don't know. I don't feel right.

Thinking of pain returns I'll go in

ISeeIt Sat 14-May-16 17:43:00


Mummyme87 Sat 14-May-16 17:57:19

From what your explaining there is no real cause for concern re. Placental abruption. Not sure why your midwife suggested abruption as your fundal height was reduced as that's not associated.

Sounds like you need lots of fluids, rest, sleep and paracetamol. Sounds like you have had a rough pregnancy. Hope you feel better soon

WorriedOrStressed Sat 14-May-16 17:58:16

Please ring your maternity triage number (should be on your hand-held notes). You are pre-term and contracting. Regardless of whether or not you are at risk of placental abruption (multiparty is a risk and absence of bleeding does not preclude this), you should be there, especially as "you don't feel right". I am concerned because of your other admissions they may be treating you as a 'frequent flyer'….. You need to push for readmitting, especially if contractions continue. If your uterus feels 'hard' between contractions, this could be signs of an abruption. Push for a scan. They should also be offering you steroids for fetal lung maturity. In terms of your paleness, are you anaemic (this is another risk factor for placental abruption)?

WorriedOrStressed Sat 14-May-16 18:01:18

Mummyme87, APH is associated with reduced growth as the placenta is not functioning properly.

InvoicedAgainFFS Sat 14-May-16 18:06:27

Go back in now, call on the way to let them know. They'll want to see you

ISeeIt Sat 14-May-16 18:12:17

I have been anaemic but am on ferrous sulphate and haem reading yesterday was 109, I think - so just normal?

Yes Worried - it was the lack of growth she associated with PA I believe.

I'm not contracting now - bump does still feel hard but I've been resting in bed all day (thank god for the weekend and DH being home) and it is the fact that I'm not actively contracting (particularly not now experiencing the long tightenings) that make me question whether I need go in - I'm still not clear as to whether with PA (even grade 1), once contractions and pain begin to indicate the separation, whether they'd die down at all or just continue to intensify?

I hope I wouldn't be viewed as a frequent flyer - I often worry the opposite (I have used a doula for my births and am hospital and intervention averse as far as is reasonable) but they didn't seem keen to investigate further yesterday. My instinct is that a scan would have been the best strategy - I know sometimes placental abruption is concealed even on ultrasound but it may have at least backed up/refuted the bump measurements that suggest lack of/very slow growth

ISeeIt Sat 14-May-16 18:14:58

my MW had booked me for an urgent growth scan anyway, but in my area the us departments are continually backed up and it was booked for a week Sunday! When I asked yesterday whether they would do one, the obstetrician said, 'ermmm essentially no, not today. You can stay in and take your chances'.. Which wasn't v encouraging

WorriedOrStressed Sat 14-May-16 18:21:42

hB is good. If uterus feels tender/hard despite contractions you need to go back. Trust your instincts. If a woman is worried I take her seriously.

ISeeIt Sat 14-May-16 18:28:12

Thank you

idontlikealdi Sat 14-May-16 18:31:08

Hi I had an abruption at 31 weeks, no pain, no bh, no tightening. Was very lightheaded and had some bleeding but not huge amounts for about 24 hours and then there was well, a lot.

WorriedOrStressed Sat 14-May-16 18:35:04

This is what concerns me OP what Aldi experienced. As this is 4th pregnancy you could quickly labour and/or abrupt and haemorrhage. Worst case scenario I know but it's better you get checked out.

ISeeIt Sat 14-May-16 18:45:56

💐 Aldi - how did it turn out? Lightheaded yy. Also mw mentioned v low temp - don't see how this would relate though? Oh god do I have to go in again, I hate it so and will be so peeved if they just send me home without any further explorations

Didactylos Sat 14-May-16 18:48:18

please phone in and ask to be assessed as an emergency tonight
it doesn't feel right to you
you know its possible to have a concealed abruption
I hope everything is ok for you, but please make that call now

AnotherStitchInTime Sat 14-May-16 18:52:40

I don't know about abruption, but you do sound like you could be dehydrated.

ISeeIt Sat 14-May-16 18:56:26

I think I may have been dehydrated, but I had a drip in a and e and the urine sample after didn't show ketones or anything, I've been conscious about drinking today.

Ok. I think I will call. Oh I don't know, I really don't want it to be a fuss over nothing

Afreshstartplease Sat 14-May-16 18:59:55

Hope all is well op

Alb1 Sat 14-May-16 19:00:59

OP I thought the same thing about not making a fuss and it didn't turn out well for my baby, And I have to live with that regret now. Sorry I'm not meaning to sound pushy, I just no personally I'd much rather make a fuss than take a risk, and all the midwives I came across when I eventually did go to hospital deffiently would have agreed with that too. You will probably go in and be home in a few hours feeling silly for making a fuss, but atleast youl have that peace of mind

idontlikealdi Sat 14-May-16 23:28:06

Isee - DTs born at 31+3, 5 weeks in hospital, no issues at all. I had 5 bags of blood transfused, can't remember the volume now.

DTs are 5, we were very very lucky.

How are you doing now?

WorriedOrStressed Sun 15-May-16 09:04:32

OP how are you?

ISeeIt Sun 15-May-16 09:20:52

I'm so sorry Alb1. That is unimaginably awful and you are right

Aldi I'm so pleased you were lucky and everything turned out OK for you all.

I spoke to my MW (who is also my friend) last night. She said if pain persists/returns, just go in. I dozed off debating it with DH and slept through, which means the pain didn't come back, or at least not enough to wake me up as before.

I have a consultant appointment on weds anyway (just to sign off homebirth) and scan on Sunday. I think it probable I was just laid v low from the bug and d&v perhaps irritated my already pretty irritable uterus? It's tricky, my instinct was definitely saying something wasn't right before but now the lasting contractions have subsided I am doubting all that.

my strategy is going to be to rest as much as possible, since that seems to have helped, but be ready to go in at the first sign of previous or additional symptoms. I do wish they'd scanned on Friday, but I don't think they'd rush to do it with me presenting as I am now.

Thank you so much all for your replies. I will keep you updated

WorriedOrStressed Sun 15-May-16 09:23:06

Sounds like a good plan. Good luck with it all OP flowers

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