ABRUPTIO PLACENTA

ABRUPTIO PLACENTA
Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.
Causes
Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident
Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered)
Risk factors include:
Blood clotting disorders (thrombophilias)
Cigarette smoking
Diabetes
Drinking more than 14 alcoholic drinks per week during pregnancy
High blood pressure during pregnancy (about half of placental abruptions that lead to the baby's death are linked to high blood pressure)
History of placenta abruptio
Increased uterine distention (may occur with multiple pregnancies or very large volume of amniotic fluid)
Large number of past deliveries
Older mother
Premature rupture of membranes (the bag of water breaks before 37 weeks into the pregnancy)
Symptoms
Abdominal pain
Back pain
Frequent uterine contractions
Uterine contractions with no relaxation in between
Vaginal bleeding
Treatment
Treatment may include fluids through a vein (IV) and blood transfusions. The mother will be carefully monitored for symptoms of shock. The unborn baby will be watched for signs of distress, which includes an abnormal heart rate.
An emergency cesarean section may be needed. If the baby is very premature and there is only a small placental separation, the mother may be kept in the hospital for close observation. She may be released after several days if the condition does not get worse and any bleeding stops.
If the fetus is developed enough, vaginal delivery may be done if it is safe for the mother and child. Otherwise, a cesarean section will be done.
On June 13, 2012 - I was heading into the doctor's for a routine check-up, I was about exactly 32 weeks. My appointment was at 9:15. I was feeling perfectly fine, my only complaint in retrospect was a mild back-ache.
I went to go pee in the cup and noticed very very faint pink discharge on my underwear. I almost didn't say anything it was so faint, but I figured I was at the doctor's so what the heck. I told them and they did an exam and didn't really see much in terms of bleeding, though she thought my cervix felt just a bit "thin" (still not sure what that means). They did an ultrasound and saw that the cervix was measuring "2" but they like to see like "2.5" or something like that for 32 weeks. There was some faint bleeding at this point.

My doctor decided to have me go next door to the hospital for observation (thank goodness I went to the main office at the hospital instead of the satellite office). She said, I'm just being overly-cautios here, I'd like to just have you monitored for a couple hours to make sure you aren't in labor and to watch the baby. They wheeled me over and when I changed into a robe I noticed a small clot and a bit of bleeding in my underwear by this point (I showed the nurse). They had me lie in the bed, and strapped monitors to me to check for contractions and to watch the baby's heart beat. I was under monitoring for maybe 5 min max when the nurse asked if I felt "that". I didn't really, but apparently it was a contraction (I'm a FTM, so I didn't know). The baby's heart rate at this point was fine (~ 130-140). But then all of a sudden alarms starting going off and the nurse started shouting into an intercom. The baby's heart rate had plummeted to 60.

All of a sudden there were like 7 people in the room around my bed. They had me move to various positions, but his heart rate didn't come back up. (Apparently at this point I also had an embilical cord prolapse, which is also NOT good). The doctor in scrubs standing over me said that they were going to have to do an emergency c-section. I think I just gaped numbly at him. He repeated it and I nodded. They immediately started pushing by bed down the hall....they were running me down the hall to the operating room. It was so surreal, like a scene from a medical tv-show.
Once in the operating room, they had to knock me out with general anesthesia. There was no time for an epidural. Apparently my baby was born at 10:30 am. 32 weeks gest, 4lbs, 5 oz, 17 lbs, and he scored 9's on his Apgar's. They immediately transported him to a hospital in the city with a NICU. They were wheeling me out of surgery where we crossed paths with my baby's transport team in the hallway. They stopped and let me look at him. This was when I learned I had a son. All I remember is that he was pink, and that made me happy, and that I couldn't believe it was a boy (I was convinced we were having a girl). They asked if we had a name picked. We hadn't decided on a name yet, we thought we still had 2 months to decide. So he went to the hospital as "Baby Boy". I was able to touch his foot before they left. They transported me to the same hospital later that night so we would be in the same place. I finally was able to contact my husband an hour later, and the doctor explained what happened. I've never heard my husband cry before that. He rented a car and drove the 9 hours home to be with me. He arrived at 11:30 at night and we went to go see our son together for the first time. It would be 6 days until we could hold him.

Our little boy, Brendan, was on a ventilator 5 days, and a nasal canula for nearly 5 weeks after that. He was in the NICU for 7 weeks. He came home on Aug 1st. I spent every day in the hospital with him, 8 hrs a day. Every night when I left, I would break out in hives.
My doctor has diagnosed me with PTSD and mild PPD. I am still struggling a bit. I can't stop thinking about what happened. I am 33 years old, extremely healthy, no health problems, no bad habits. The doctor's don't know why I had a placental abruption. They called it a silent one because I had no pain and wasn't showing a lot of blood. I had about a 30% tear. I'm terrified to even think about having any more children with what happened.