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Sharp Health News

Listen to your body and trust yourself

Dec. 22, 2020

Woman holding infant in front of Christmas tree
When she was 34 weeks pregnant with her first child, Amanda Joachim woke up one morning feeling a little off.

Overall, Amanda had felt great throughout her pregnancy. She experienced high blood pressure at her OBGYN appointments, but her bloodwork always came back normal.

"That morning, there was more pressure and cramping than usual in my abdomen, but I just wrote it off as Braxton Hicks," Amanda says, referring to the false labor contractions that many women experience later in pregnancy.

On the way to work, the cramping intensified and her back began to ache. Once she arrived at work, Amanda wanted to make sure everything was OK and went to the bathroom, where she saw an excessive amount of blood in the toilet. She immediately had a co-worker drive her to Sharp Mary Birch Hospital for Women & Newborns.

"I have never been more scared in my whole life," she says. At the hospital, she couldn't feel the baby move, but nurses put a heart rate monitor directly on Amanda's belly that revealed her daughter's strong heartbeat.

When the doctor performed an ultrasound, Amanda learned she was experiencing a placental abruption and was immediately diagnosed with preeclampsia, a pregnancy complication marked by high blood pressure and organ damage. Amanda had never heard of a placental abruption and didn't know what it meant for her and her baby.

According to Dr. Craig Saffer, an OBGYN affiliated with Sharp HealthCare and medical director of minimally invasive surgery at Sharp Mary Birch Hospital for Women & Newborns, a diagnosis of preeclampsia is usually only made after the 20th week in pregnancy, and initial diagnosis can be challenging if the only sign is occasional mildly elevated blood pressure.

Approximately 1 in 100 pregnancies experience placental abruptions, usually in the third trimester. It occurs when the placenta, which supplies oxygen and nutrients to a growing baby, separates from the uterus before childbirth, causing a possible - and occasionally rapid - decrease in the oxygen supply to the baby.

Symptoms may include vaginal bleeding, lower-abdominal pain, back ache and low blood pressure.

Amanda continued to lose blood. She had an emergency C-section and delivered her daughter, Lennon, who was taken to the Sharp Mary Birch Neonatal Intensive Care Unit (NICU). Lennon remained in the NICU for three weeks, initially needing 100% assistance breathing for the first four days, and stayed for the following weeks to increase weight and feed directly from the bottle.

"My doctors were miracle workers and told me after the fact that if I had come into the hospital any later, my outcome may not have been the same," says Amanda.

In addition to preeclampsia, which Amanda experienced, other factors can lead to placental abruption, including:
  • Trauma to the uterus, such as a car accident
  • Placental abruption in a previous pregnancy that wasn't caused by abdominal trauma
  • Chronic high blood pressure (hypertension)
  • Hypertension-related problems during pregnancy, including HELLP syndrome or eclampsia
  • Smoking
  • Cocaine use during pregnancy
  • Being older, especially over age 40
"In some cases, placental abruption develops slowly - called a chronic abruption, which can cause light, intermittent vaginal bleeding," says Dr. Saffer. "Your baby might not grow as well as expected, and you might have low amniotic fluid or other complications."

In other cases, placental abruption can cause life-threatening problems for both mother and baby.

"For the mother, placental abruption can lead to significant blood loss, blood clotting problems (also called DIC), need for blood transfusion, and failure of kidneys or other organs due to blood loss," says Dr. Saffer. "For the baby, there is a possibility of restricted growth from not getting enough nutrients, if this is a chronic condition, or the baby not getting enough oxygen and even in some cases, stillbirth, if this happens suddenly."

Amanda feels lucky that Lennon is home and healthy. Her words of advice for anyone pregnant: Listen to your body, ask questions and trust yourself.

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