Can anyone explain more about placental abruption?

[Eulalia]

I had my 3rd baby 6 weeks ago by emergency C/S. I was totally unprepared for this as my previous 2 labours were fairly straightforward. However I recovered very quickly and have come to terms with it. However various questions float round my head from time to time and I feel that I'd like to know more about what happened.

I wrote out the whole experience here if anyone wants to read it, but basically it was a suspected placental abruption. I have read up on this here on this paper which was very informative.

Are there any midwvies (mears, pupuce?) who can tell me a bit more....

What is a hypertonic uterus?

The paper mentions maintinaing a 'left lateral tilt' during labour and indeed I had to lie like this but am not sure why.

It also states abruption is more common with age and parity. Is my age (just coming up to 40 at the time of birth) significantly old?

I was giong to discuss some of this at the GPs at my post-natal check but the doctor didn't seem to know anything about my birth and besides there didn't seem to be time to delve into all this.

Thanks very much.

Anyone?

Hi Eulalia. Thought I might be able to help but your questions are quite specialised. You really need an obstetrician for this! I've read the paper you linked to and the only reason I can think of for a left lateral position is to relieve pressure on the aorta (the main blood vessel) as the mother is likely to have a low circulating blood volume and pressure on the aorta would compromise this further. A hyperkinetic, hypertonic uterus just means contracting. As to your age , if it was your first baby you would be seen as older than average but I can't tell you how relevant that would be. As to parity I believe the risk is higher for fourth or more pregnancies. Hope this helps a little.

Thanks. lockets - yes I know it can be serious early on and I was lucky to have gone to term.

Thanks KateF - I think you have explained it pretty well. Actually I am not convinced that it was an abruption or maybe it was just a partial one. The house doctor wasn't certain herself and I think the CS was more of a precaution really but better to be safe than sorry.

I've read your birth thread now and it does sound a bit inconclusive but luckily you had good management and a safe delivery. Hope baby Paul is thriving.

KateF - are you a midwife?

Hi Eulalia - there are a number of reasons why abruption happends but TBH it can be very hard to pinpoint the exact cause. Although it can be common in older women that does not mean age causes it. Very ofetn it is most associated with high blood pressure.

Left lateral position encourages better blood flow through the placenta and avoids compression of the aorta - the main blood vessel transporting blood through the body.

Hypertonic means when the uterus is in a state of permanent contraction which can cause the placenta to start to separate from the wall of the womb which is, in essence, an abruption.
You will never get to the root of why it happened, but by the sound of things it was appropriate to intervene with a C/S prevent oxygen deprivation of your baby. Does that help?

Thank you mears. Very helpful. So was I not in 'real' labour then? ie the contractions weren't labour contractions but due to the placenta coming away. Or could it have been a bit of both, after all I was at term. My waters had broken too but I guess this isn't necessarily a sign of labour starting either. I suppsoe there is no point in speculating. This is my last baby so it doesn't really matter.

You could very well have been in real labour Eulalia with an abruption as well. All was well in the end though which is all that matters.