placental abruption

In January 2007, I found out that I was pregnant, afew wks later I started spotting and having abdominal cramping. I had a trans-vaginal ultra-sound which detected nothing. Baby was well attached no bleeding in the sac,good heart beat etc etc. I went through several medications due to severe hyper-emesis and lost about 15 pounds. At 20 weeks the nausea had subsided which was a big relief to me because I could now eat. My ultrasound sound at 20 wks showed that I was having a girl and that every thing was okay. At 25 weeks I woke up one morning with severe lower back pain and some bleeding, I got to the hospital but by the time I got there my daughter had already passed away! When she was born they found a large blood clot adhered to the placenta and my doctor at the time believed I also had a placental abruption. I have never been at peace with this, I am currently trying to concieve (conceive) and im just wondering if it is possible that I may have a blood clotting disorder or was the blood clot on my placenta trying to repair the slowly rupturing placenta? Is there such a thing as genetic placental disorders? the reason I ask is because my sister also had a baby that was born prematurely due to placental insufficiency. Any help would be greatly appreciated!

[Keith Downing, MD]

Hello,

After your loss you should have had an evaluation that among other things included a panel of tests to look for inherited and acquired thrombophilias (the propensity to form clots).  The other important thing to have been noted is whether you had any issue with hypertension of pregnancy at the time of the loss.  

Before you continue your attempts at conception you should visit with your ob/gyn to discuss whether you have indeed had a full work up for your prior loss, the potential risks of a subsequent pregnancy, how you may be able to decrease those risks and how you would be followed.

Best regards,

Dr. Downing