Hospital Visit

Thursday morning, around 9:30, I was on the computer after getting Harleigh off to school when all of the sudden I felt like I wet my pants. My first initial thought was oh no....did my water just break? When I got to the bathroom I realized I had just lost a bunch of blood. This came as a huge surprise since this hasn't happened since the week before Thanksgiving. I was so nervous and scared that I couldn't even concentrate on who to call. I think it took me about 10 min. (or so it felt) to find the Dr.'s number in my cell phone. After talking to them, I was instructed to make my way down to Maternal Observation. Jarrod picked me up and off we went. We got right on in but I think we waited about three hours before we got a sono. The baby was great, amniotic fluid was good, placenta looked to be okay and it was high in the uterus so placenta previa was ruled out. They checked my cervix and it had shortened to about 2.03cm so this could be maybe a source or it could be the beginning of placenta abruption. The Dr. then admitted me to the hospital for a 24 hour observation. Not what I expected at all. That night I stayed at the hospital by myself as Jarrod had responsibilities at home. All the stress tests they ran on the baby looked great. I also hadn't had anymore bleeding so Friday morning I was going to be discharged around 11am. Jarrod came to get me and as the nurse was putting together the discharge papers, I got dressed. While I was in the bathroom, I passed a bunch of blood clots and some more bright red blood. I was hesitant to say something to the nurse but my guilty conscience got the best of me and I spoke up. The nurse called the doctor and then came back and said that I wasn't going anywhere and that the doctor wanted to keep me throughout the weekend. I think I cried for the next hour. Jarrod quickly left since Harleigh had early dismissal but they both came back and spent the afternoon with me. My sister-in-law Lauren and my co-worker Carolyn came by to visit me also. It was nice to talk and chit chat with them. Then that evening, Mom, Dad, Bob & Cindy came up & visited and then took Harleigh home with them. Jarrod stayed the night with me on the hard couch. Poor guy! Then to our surprise, this morning, the Dr. said we could go home instead of staying through the rest of the weekend. Thank goodness! I think we finally got home around 1:30pm. I am now on strict bed rest with bathroom and meal privileges only. If I start spotting or bleeding again, don't feel the baby move as much or start having pain then I have to head straight back down to the hospital. Hopefully, Rhett will want to stay warm & cozy for at least a couple more weeks. Thank you all for your prayers!

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What is a placental abruption?

A placental abruption is a serious condition in which the placenta partially or completely separates from your uterus before your baby's born.

The condition can deprive your baby of oxygen and nutrients, and cause severe bleeding that can be dangerous to you both. A placental abruption also increases the risk that your baby will have growth problems (if the abruption is small and goes unnoticed), be born prematurely, or be stillborn.

Placental abruption happens in about one in 200 pregnancies. It's most common in the third trimester but can happen any time after about 20 weeks.

How can I tell if I'm having a placental abruption?

In most cases, you'll have some vaginal bleeding, ranging from a small amount to an obvious and sudden gush. Sometimes, though, the blood stays in the uterus behind the placenta, so you might not see any bleeding at all.

Most women will have some uterine tenderness or back pain. And in close to a quarter of cases, an abruption will cause the woman to go into labor prematurely.

If you have any signs of a placental abruption, you'll need to go to the hospital for a complete evaluation, including fetal heart rate monitoring and an ultrasound. (An ultrasound can't necessarily detect a small abruption, but it can rule out placenta previa, the other likely cause of uterine bleeding.)

Since the bleeding may not be from the uterus, your practitioner will examine your vagina and cervix to see if the bleeding is from an infection, a laceration, a cervical polyp, or some other cause. She'll also check to see if your cervix is effacing or dilating, which can disrupt small veins and result in some bleeding.

Call your practitioner immediately if you have any of these signs:

• Vaginal bleeding or spotting, or if your water breaks and the fluid is bloody
• Cramping, uterine tenderness, abdominal pain, or back pain
• Frequent contractions or a contraction that doesn't end
• Your baby isn't moving as much as before

Call 911 if you're bleeding profusely or have any signs of shock — if you feel weak, faint, pale, sweaty, or disoriented, or your heart is pounding.

What will happen if I have a placental abruption?

If you're near your due date, you'll need to deliver your baby right away, even if the abruption is minor, because the placenta could separate further at any time. In most cases, you'll have a c-section.

However, if you have a small amount of bleeding that your provider suspects is from a minor abruption, and you and your baby are doing fine, you may be allowed to labor, as long as you're at a hospital where an emergency c-section can be done at the first sign of trouble.

If your provider suspects that you have a minor abruption and your baby is very premature, you may be able to delay delivery a bit, as long as you and your baby are doing fine. At this point you have to weigh the risk of a worsening abruption against the risk of a premature birth.

You may be given corticosteroids to speed the development of your baby's lungs and to prevent certain other problems related to prematurity. You'll stay in the hospital and be monitored continuously so your medical team can get your baby out at the first sign that the abruption is getting worse or that you or your baby is no longer doing fine.

Who's most at risk for placental abruption?

No one knows for sure what causes most cases of placental abruption, but the condition is more common in women who:

• Had an abruption in a previous pregnancy (and if you've had an abruption in two or more pregnancies, the risk is even higher)
• Have chronic hypertension, gestational hypertension, or preeclampsia
• Have a blood clotting disorder
• Have their water break prematurely
• Have to much amniotic fluid (polyhydramnios)
• Had bleeding earlier in their pregnancy
• Are carrying multiples (abruption is especially common just after the first baby is delivered)
• Are involved in an accident (particularly a car accident), are assaulted (with blows to the abdomen), or have other trauma to the abdomen
• Smoke tobacco or use cocaine
• Have had many babies or are older (the risk gradually goes up with age)
• Have a uterine abnormality or fibroids (particularly if there's a fibroid behind the place where the placenta is attached)