Placental Abruption in Grand Rapids, Michigan

Placental abruption is a serious pregnancy complication in which the placenta partially or completely detaches from the wall of the uterus before birth. This can cause heavy bleeding in the mother and reduce or cut off the baby’s supply of oxygen and nutrients.

In Grand Rapids and across West Michigan, placental abruption is considered an obstetric emergency and is treated at major birthing hospitals such as Corewell Health (formerly Spectrum Health) Butterworth Hospital, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and other local maternity units.

Why Placental Abruption Is Dangerous

Bleeding in the Mother

When the placenta pulls away from the uterine wall, blood vessels can tear and cause internal or external bleeding. Sometimes the blood is visible as vaginal bleeding; other times it is trapped behind the placenta.

Reduced Oxygen and Nutrients for the Baby

The placenta carries oxygen and nutrients from the mother’s bloodstream to the baby. When it detaches, the baby can become deprived of oxygen, which may lead to:

  • Fetal distress
  • Brain injury
  • Stillbirth in severe cases

The Placenta Cannot Be Reattached

Once placental abruption occurs, doctors cannot reattach the placenta. Treatment focuses on:

  • Stabilizing the mother
  • Monitoring the baby
  • Deciding when and how to deliver

Without prompt medical care, severe placental abruption can be life-threatening for both mother and baby.

How Common Is Placental Abruption?

Worldwide, placental abruption occurs in about 1 out of every 100 pregnancies. Generally:

  • About 50% of cases are mild and can be managed with close monitoring.
  • About 25% are moderate.
  • About 25% are severe and may threaten the lives of both mother and baby.

In Grand Rapids, pregnant patients with suspected placental abruption are typically managed in hospital settings with continuous fetal monitoring and access to emergency obstetric and neonatal care.

Signs and Symptoms of Placental Abruption

Symptoms can develop suddenly and may be mistaken for other pregnancy problems. Common signs include:

  • Vaginal bleeding (may be light, heavy, or sometimes absent)
  • Continuous abdominal pain
  • Continuous lower back pain
  • A tender, rigid, or “board-like” uterus
  • Pain when the abdomen is touched
  • Very frequent or constant uterine contractions
  • Signs of fetal distress (abnormal fetal heart rate)
  • Signs of shock in the mother (pale skin, dizziness, rapid heartbeat, weakness)

Retroplacental Clot (Bleeding You May Not See)

Sometimes the placenta detaches and blood collects behind it instead of flowing out through the vagina. This is called a retroplacental clot. In these cases:

  • Vaginal bleeding may be minimal or absent.
  • The uterus may feel hard, painful, and tender.
  • The baby may show signs of distress.

Because of this, severe placental abruption can occur even without obvious bleeding.

Causes of Placental Abruption

In most cases, the exact cause is unknown. Experts believe that abnormal blood flow in the uterus or placenta may play a role.

Known or suspected causes and triggers include:

Abdominal Trauma

An injury to the pregnant woman’s abdomen can tear the placenta from the uterine wall. Examples include:

  • Car accidents (a particular concern in winter driving conditions common in West Michigan)
  • Physical assault or domestic violence
  • Falls on ice or slippery surfaces (more likely during Michigan’s snowy and icy winters)
  • Significant blunt trauma to the abdomen

Uterine Decompression

A sudden loss of amniotic fluid can “pull” the placenta away from the uterine wall. This may occur:

  • After the birth of the first baby in a twin or multiple pregnancy
  • After rupture of the amniotic membranes when there is excessive amniotic fluid (polyhydramnios)

Risk Factors for Placental Abruption

Certain factors increase the risk of placental abruption. These include:

  • Advanced maternal age (older mothers are at higher risk for several pregnancy complications)
  • Hypertension (high blood pressure)
    • Chronic high blood pressure
    • Pregnancy-induced hypertension
    • Preeclampsia, a common cause of high blood pressure during pregnancy
      Nearly half of placental abruption cases occur in women with hypertension.
  • History of placental abruption in a previous pregnancy
  • Multiple fetuses (twins, triplets)
  • Excess amniotic fluid (polyhydramnios)
  • Substance use, including:
    • Cigarette smoking
    • Illicit drugs (especially cocaine)
    • Alcohol misuse
  • Certain blood or clotting disorders
  • High number of prior pregnancies (risk increases with each pregnancy)
  • Abdominal trauma, including car crashes and falls
  • Invasive procedures, rarely:
    • Amniocentesis (needle test to sample amniotic fluid)
    • Amnioreduction (removal of excess amniotic fluid)
    • External cephalic version (ECV) (a procedure to turn a breech baby)

In Grand Rapids and Kent County, managing high blood pressure, smoking, and substance use during pregnancy is a major focus of prenatal care, given their strong association with complications like placental abruption.

Procedures That Rarely Trigger Abruption

Some medical procedures in pregnancy carry a small risk of causing bleeding or placental abruption:

Amniocentesis

A needle is inserted through the mother’s abdomen into the uterus to collect amniotic fluid for testing. Very rarely, the needle puncture can cause bleeding or contribute to placental separation.

Amnioreduction

Used to treat polyhydramnios (too much amniotic fluid). A needle is used to remove excess fluid. This procedure uncommonly causes bleeding or placental abruption.

External Cephalic Version (ECV)

During ECV, a doctor uses ultrasound and gentle pressure on the mother’s abdomen to turn a baby from a breech (head-up) position to a head-down position. Very rarely, this can dislodge the placenta and lead to abruption.

These procedures are typically performed in hospital settings in Grand Rapids—such as Corewell Health or Trinity Health Grand Rapids—where emergency care is immediately available if complications occur.

Possible Complications of Placental Abruption

If not treated promptly, moderate to severe placental abruption can cause:

For the Baby

  • Decreased oxygen supply, which can lead to brain damage
  • Premature birth
  • Growth restriction
  • Stillbirth (fetal death)

For the Mother

  • Severe blood loss (hemorrhage)
  • Shock (dangerously low blood pressure)
  • Need for blood transfusion
  • Emergency hysterectomy (surgical removal of the uterus) if bleeding cannot be controlled
  • Rarely, maternal death from severe blood loss

How Placental Abruption Is Diagnosed

The symptoms of placental abruption can resemble other pregnancy conditions such as placenta previa and preeclampsia. A thorough evaluation is needed.

Information and Tests Used for Diagnosis

Healthcare providers in Grand Rapids may use:

  • Medical history
  • Physical examination
    • Checking uterine tenderness and tone
    • Assessing the abdomen and vital signs
  • Pelvic examination of the vagina and cervix (using a speculum, when safe)
  • Fetal heartbeat monitoring (continuous electronic fetal monitoring)
  • Blood tests, including:
    • Blood count
    • Clotting studies
    • Blood type and cross-match (in case transfusion is needed)
  • Ultrasound to:
    • Check the location and appearance of the placenta
    • Assess the baby’s well-being
    • Look for signs of bleeding

Sometimes the diagnosis can only be confirmed after delivery, when the placenta is examined and an old blood clot is found attached. The placenta is usually sent to a laboratory for further testing.

Treatment of Placental Abruption in Grand Rapids

All suspected cases of placental abruption—mild to severe—should be closely monitored in a hospital. In Grand Rapids, treatment is typically provided in labor and delivery units at hospitals such as:

  • Corewell Health Butterworth Hospital
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health
  • Other regional hospitals within West Michigan

General Principles of Treatment

  • Monitor mother’s vital signs (blood pressure, heart rate, oxygen level)
  • Monitor fetal heart rate and contractions
  • Check bleeding and pain levels
  • Prepare for possible emergency delivery

Treatment depends on:

  • How much of the placenta has detached
  • The amount of bleeding
  • The baby’s gestational age
  • The baby’s condition (distressed or stable)
  • The mother’s overall health

Mild Cases, Earlier in Pregnancy

If the abruption is mild, the baby is not in distress, and bleeding is limited:

  • Hospital observation and bed rest
  • IV fluids and monitoring
  • Possible short stay in the hospital followed by home rest
  • Regular follow-up visits with your obstetrician or midwife
  • Instructions to return immediately if:
    • Bleeding increases
    • Pain worsens
    • Baby’s movements decrease

Moderate Cases, Earlier in Pregnancy

If the abruption is moderate but the baby is still premature:

  • Hospital admission, often until delivery
  • Continuous monitoring of mother and baby
  • Medications such as corticosteroids to help the baby’s lungs mature faster
  • Careful decision-making about the timing of delivery, balancing:
    • The risk of continued abruption
    • The benefits of more time for the baby to grow

Mild to Moderate Cases, Later in Pregnancy

If the pregnancy is 36 weeks or more and the abruption is mild to moderate:

  • The doctor may recommend delivery.
  • A vaginal birth may be possible if:
    • Bleeding is controlled
    • The baby is stable
    • The placenta is not separating further
  • If the placenta separates more during labor or the baby becomes distressed, the team may switch to an emergency cesarean section.

Severe Cases

In severe placental abruption:

  • Immediate delivery is usually the safest treatment for both mother and baby.
  • An emergency cesarean section is often required.
  • The mother may need:
    • Blood transfusions
    • Intensive monitoring
    • In rare cases, an emergency hysterectomy if bleeding cannot be controlled

Supportive Care for the Mother

Depending on the severity, supportive care may include:

  • IV fluids
  • Blood transfusions
  • Oxygen therapy
  • Medications to control blood pressure and prevent complications
  • Postpartum monitoring in a high-dependency or intensive care unit, if needed

Newborns affected by placental abruption may need care in a Neonatal Intensive Care Unit (NICU), which is available at major Grand Rapids hospitals.

Can Placental Abruption Be Prevented?

Placental abruption cannot be completely prevented, but you can reduce your risk by managing certain factors—especially in a region like West Michigan, where winter weather and driving conditions can increase the risk of falls and car accidents.

Ways to Lower Your Risk

  • Avoid harmful substances during pregnancy:
    • Do not smoke.
    • Avoid alcohol.
    • Avoid all recreational or street drugs.
    • Only take medications prescribed or approved by your healthcare provider.
  • Control high blood pressure:
    • Attend all prenatal appointments.
    • Take blood pressure medicines exactly as prescribed.
    • Follow your provider’s advice on diet, activity, and monitoring.
  • Reduce risk of trauma:
    • Always wear a seatbelt properly when riding in a car.
    • Use extra caution when driving in snow, ice, and wet conditions common in Grand Rapids winters.
    • Use handrails and wear appropriate footwear to prevent falls on ice or wet surfaces.
  • Discuss your history:
    • Tell your doctor if you had placental abruption in a previous pregnancy.
  • Manage multiple pregnancy risks:
    • If you are carrying twins or more, follow your specialist’s recommendations closely.
  • Take prenatal vitamins:
    • Take folic acid and prenatal vitamins as recommended by your doctor or midwife.
  • Seek help for domestic violence:
    • If you are experiencing violence or feel unsafe at home, talk to your healthcare provider or contact local support services in Grand Rapids.

Local Resources in Grand Rapids, Michigan

If you have concerns about placental abruption or pregnancy complications, contact:

  • Your OB-GYN or midwife
  • Corewell Health (Spectrum Health) – Women’s Health & OB Services
  • Trinity Health Grand Rapids – Obstetrics & Maternity Care
  • Metro Health – University of Michigan Health – Women’s Health Services

Public Health Support

  • Kent County Health Department
    Offers prenatal education, WIC nutrition services, and referrals to obstetric care in Grand Rapids and surrounding communities.

  • Grand Rapids Public Health and Community Clinics
    Provide resources for prenatal care, smoking cessation, and substance use support.

In an emergency—such as heavy bleeding, severe abdominal pain, or decreased fetal movement—go immediately to the nearest emergency department or call 911.

Key Points About Placental Abruption

  • Placental abruption occurs when the placenta detaches from the uterus before birth.
  • It can cause dangerous bleeding in the mother and reduce oxygen to the baby.
  • About 25% of cases are moderate and 25% are severe, threatening the lives of both mother and baby.
  • In most cases, the exact cause is unknown, but risk factors include high blood pressure, abdominal trauma, substance use, and previous abruption.
  • Car accidents, assaults, and falls (especially on ice in Michigan winters) can trigger placental abruption.
  • The placenta cannot be reattached; treatment focuses on stabilizing mother and baby and deciding the safest time and method of delivery.
  • Immediate hospital care in Grand Rapids is essential if placental abruption is suspected.

If you are pregnant in Grand Rapids and experience vaginal bleeding, severe abdominal pain, or notice your baby moving less than usual, seek urgent medical care right away.