partial plancental abruption 27+ weeks now what?

[nurnur]

my neice (who is looking for all the info she can get and doesn't mind me sharing!) just experienced a parital plancental abruption last night at 27+ weeks gestation. She went to her local hospital and they did an ultrasound there and then sent her on to a larger hospital where they did another ultrasound and could tell her that it apprears she had a significant abruption. Her bleeding has now pretty much stopped, her cervix does not show changes, she is not experiencing consistent cntx, just the regular toning cntx that she was having before here and there. Her baby sounds great. She did consent to the injection of steroids in case she delivers now. They want to keep her 36-48 hrs for further observation. The ob told her she has 1/3 chance things will get worse, 1/3 chance things will stay the same, 1/3 chance things will improve. She has a mw and was planning a homebirth, however her mw is out of the country right now and her on-call system did not seem to be worked out. My neice is feeling very shaky about the care and support available to her from this mw as she was not able to get a return call from the apprentice or back-up for 12 hours. So what Im really looking for is any info/advice on placental abruption and where we can go from here and what to expect.

[homebirthing]

She needs to get tested for blood clotting disorders ASAP. And she should talk to the doctor about starting baby aspirin as well.

Sarah

[jlpetitte]

Sarah~

Could you explain your rationale for those interventions? I just don't really understand how that would relate to abruption.

[tlcdoula]

Hopefully Sarah will answer, but I believe that some blood clotting disorders can lead to an abruption. I know right now I am working with a client who has a clotting disorder and one of the concerns if she goes to term is an abruption due to her disorder.

[loudmama]

I had an abruption at about the same time with my DS. After they realized what it was, they put me in the hospital on bedrest. I had 3 instances of bleeding in about a week before it really showed up to be a small abruption. With an abruption, the situation can be catastrophic for both the mother & the baby. Mom has a risk of bleeding out & baby can die from not getting what it needs from the placenta. If she abrupts suddenly & badly, they will need to do a c-section under GA. This is nothing to take lightly. My doula was a midwife, & after talking with her, I knew that the OB I had to switch my care to was not over reacting to the situation.

All is not lost though if she is hoping for at least a lower intervention delivery. A week into my hospital bedrest my water broke. Within about 1/2 hour of that I had a VERY quick VBAC to a 5lb 2oz baby boy. He spent 3 1/2 weeks in the NICU to grow.


That's just the brief version of my story. Feel free to PM me to "talk" more.

L