Placental abruption

[Katsma]

My first baby was born by emerg c/s due to foetal distress. The surgeon came to see me the following day and told me that they had found blood behind the placenta caused by a concealed abruption.

Am thinking about trying for a second baby, and know that the risk is increased with a previous abruption.

Also, would I be advised to have an elective c/s, or try for a VBAC?

Anyone know anything?

Hi Katsma

Can I ask a few of questions?

What gestation were you when you delivered?

Were you in labour when the abruption occured?

If you were in labour, how far dilated were you?

Was it a category 1 section ?

The answers will help to clarify and help with any advice.

I was 40+6.

I went into natural labour at 4am at home. Was fine until 8am when I went for a wee. There was a sudden MAAAASIVE gush of blood (TMI sorry) down the toilet. Phoned maternity in a panic. They said to hold a maternity pad in position so they could see the type and quantity of blood, and sent an ambulance. Contraction intervals were varying between 35mins and 3mins.

But when I arrived at the hosp, the pad was virtually dry and I was hardly dilated at all. I think they thought I was making it up! (DP had to clean the loo later though and can testify that I wasn't!)

Then was in labour until 5pm with not much progress, until they decided to do a section because of foetal distress and another smaller bleed.

Sorry, don't know what cat 1 section means.

Don't know if this has a bearing, but placenta was low at 20weeks. Was rescanned at 34weeks and they said it had moved out of the way.

Hi, not a Dr so can't help. And I really think you should speak to a REAL DOCTOR rather than take advice here on such a serious medical pblm.

All I can say is that you will probably be ordered total bed rest during pregnancy and maybe hormone injections. My sister went through this for 3 out of 4 pregnancies.
eventually, placenta preavia, moved and she always delivered naturally.

You really need a pre conception check with a Dr.

Would be very interest to see what people think on this one. When I saw Katsma's post I thought I must have posted it in my sleep.

I was induced at 41+5, got to 4 cm dilated after 5 hours in labour, baby in distress, foetal bloods taken and she was low on oxygen so emergency section. Surgeon said I had clot behind placenta, which explained the foetal distress. I was terrified during the labour as (a) it was very very painful (Duh!) and (b) it felt wrong - I wanted to push during the last couple of hours.

All was well at the end of it all, so really am not fussed about the whole thing now, but have thought that a section next time would probably be the best way forward for me as I couldn't face that again. I personally blame the induction but don't know if this is correct or not.

slim22

Katsma asked if anyone knew anything about placental abruption.

Do you?

slim22 - you're right, I will of course discuss this with my doctor, just wanted to sound MN out, as people often have a wealth of experience to share

madlabowner - Oh, I wanted to push as well - everyone was looking at me like I was crazy. ("Don't be so silly, you can't push now")

Feel I was really lucky to have given birth to a baby who seemed in tip top condition (Full marks on her APGAR). Am scared about the same thing happening again if I try for a VBAC. But also scared about carrying round DD1 if I have an elective section.

Compile a list of questions and put them to your obstetrician (because once you're in the room you'll forget them!). Also, might also be worth seeking advice of a very experienced midwife (consultant midwife??), not because she is likely to undermine the obs - she just may also be able to explore the emotional impact on you and give you a bit of perspective on your available choices.

Can I seek the advice of an obstretrician and midwife before I'm actually pregnant though? Was thinking of asking my GP to refer me before even ttc.

Just realised that they must have thought I was silly. I was in my first labour, described a huge blood loss, then presented them with a maternity pad that had the amount of blood you'd expect from picking a spot!

Thanks for the response to the questions Katsma.

I am a midwifeso hope this helps

What you describe is a revealed Ante partum haemorrhage (APH)or Placental Abruption

The initial bleed from the placenta (which may have still been slightly low lying) although, frightening and a large bleed to you, was not of signicance at that time to have caused problems for the baby.

Had their been signs of fetal distress on admission, it is very unlikely that you would have been allowed to labour.

However any further loss blood loss and the stress of labour obviously resulted in fetal compromise to such a degree that delivery by LSCS was the only option for you at that stage. Either the fetal distress was very severe, or the cervix was not dilated enough for an assisted vaginal delivery.

Category ! is the most urgent for delivery.

Placental Abruption in a previous pregnancy does not necessarily mean it will happen again, no-one can ever say it will or won't.

The previous section means that you may be offered an elective section next time, or you may be offered the opportunity to try for a vaginal birth.

The decision will be yours and your obstetricians and may depend on the factors that are present in your next pregnacy, eg, no complications

Any other qustions you have I will try and answer.

Nonametoday, I know nothing thus my answer.
No need to be so full of yourself. Why not simply explain you are a midwife and more informed?
No need to be rude!

I felt your initial post was rude slim22 but refrained from saying so, but we are both allowed our opinions.

The question was does anyone know anything

You didn't I did and I truly hope my post was helpful to the Katsma

my point exactly.
Happy that katsma can take advice from an experienced medical practitioner like you.
But there is not always one on the site!

Nonametoday was very helpful.
Not really 'full of it'

storm in a teacup...........

sorry katsma did not mean to sound dismissive. You now have a proper answer that's all that matters.
Take care

I appreciate the comments slim22 and thank you.

Thank you also DarellRivers.

My posts do sound clinical to some, but I find that is the best way to get a clear picture of someone's problems and thus where I can, give the correct advice.

There is so much feeling involved with pregnancy and labour and it's sometimes impossible for the mum to fully know what happened, hence I ask the necessary questions first.

I had placental abruption with my 3rd pregnancy, and was in the hospital for about a month before dd3 was born - she was born 4 weeks early. she was fine, it was a normal delivery after a long induction process. hope you get some reassurance for your next pregnancy, and best of luck

I had a placental abruption with my first baby. I was lucky in that it happened in hospital at 40+ 1 weeks, I was in early labour. I had really gone in to the hospital too soon, but later I was very glad I had. I bled a lot, and the baby was in distress, and my baby was born by cs under GA.

I wasn't offered, and didn't want a cs with my next one, and both my second and third children were born by very straightforward, very lovely vaginal deliveries.

That's a really positive post NamelessNewbie, Just what is needed to provide a balanced view for ladies in similar situations.

Thanks Nameless - that has cheered me up immensely, just knowing it is possible to aim for a "normal" delivery next time.

Thanks nonametoday, that's a really helpful post

You're right - I am still unsure what really happened last time around. Probably the liberal use of gas/air and pethedine. Also, I think there was as much maternal distress as foetal distress! Perhaps I should start by having a look at my birth notes for this delivery.

And thanks for the posts giving me hope for a VBAC. This thread's cheered me up