The recommended treatments for a placental abruption will depend on how severe the bleeding is and how well the woman and baby are. If the bleed is not severe, then the care can be similar to
placenta previa. However, because of the risk of
DIC, the decision to induce the labour (or perform a Caesarean) is more likely than with placenta previa.
Emergency care of a placental abruption may include:
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Lying the woman on her left side, to maximise the blood flow to the baby and to the woman's internal organs. |
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Oxygen therapy for the woman, to increase the oxygen supply to herself and the baby. |
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An intravenous (IV) drip to give fluids to the woman through the vein. Sometimes a blood transfusion is required, and at times platelets are also given through the IV. (platelets are a blood product). |
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An injection of a narcotic (such as Pethidine) for the woman, if the pain from the abruption is intense. |
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CTG monitoring of the baby's heartbeat, to assess the wellbeing of the baby. |
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The caregiver rupturing the membranes (breaking the waters). This can sometimes release the pressure, but can also aggravate the bleeding. This procedure may be done in the operating theatre so a Caesarean can be done quickly, if needed. |
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An emergency Caesarean operation (or an induction of labour), depending on the health of the woman and baby, and the severity of the abruption. A general anaesthetic may be needed for the Caesarean, to avoid a further drop in the woman's blood pressure (a side effect of epidurals) and to allow the caregiver to do the operation quickly. |
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An injection of Anti-D immunoglobulin, if the woman's blood group is Rhesus (Rh) negative. A small amount of the baby's blood may move into the woman's blood stream with a placental abruption. If the baby's blood is Rhesus (Rh) positive, then this can cause an antibody reaction in the woman's blood. An injection of Anti-D immunoglobulin is aimed at preventing this reaction. An antibody reaction will not affect this baby, but will affect future pregnancies. You can read more in negative blood group. |
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Possibly blood tests for the woman after the birth to check her kidney function and/or hormone levels to exclude renal failure and damage to her pituitary gland. |