Placental Abruption & UTI: Understanding Symptoms & Treatment

Question
My sister went to the ER yesterday with abdominal and lower back pain. They did an ultrasound and the baby was very active heart beat of 164. She is 15 weeks exactly. They told her that her placenta had partially separated and she had a UTI. They put her on extreme bed rest and said if the pain got worse she should come back. They prescribed her antibiotics for the UTI and Tylenol 3 for the pain. She had a miscarriage 10 yrs ago and never didn't anything to prevent pregnancy since, but suddenly got pregnant. She went back this evening as a precaution because the pain hadn't lessened and they admitted her. They offered to give her morphine for the pain and have it ordered on standby. The doctors wont say anything, the nurses either. They wont tell her whats going on or if everythings going to be ok. From what I read its not normal for the placenta to separate so early, I also thought it was strange that they would offer her morphine. Does this mean its possible or they are expecting for her to miscarry? I can't find any cases where this happened so early in pregnancy and we would really like some idea of options and outcomes. You're advice is greatly appreciated.

Answer
Placental Separation, also known as Placental Abruption, almost never occurs before the 20th week of pregnancy and can be very difficult to diagnose so early on due to the very small size of the placenta at that time. The placenta is the baby's lifeline that delivers oxygen, blood and nutrients to the baby. If it separates from the uterine wall, not only can it cut off the baby's supply of blood, nutrients and oxygen, it can also cause a devastating loss of blood for the mother during delivery that can lead to admission to an Intensive Care Unit or worse. If the placenta is partially separated, this can be treated with strict bedrest and some alternative medications to take as a preventative measure. If the placenta is fully separated and there are more complications, they may try to deliver the baby.

It is important to know that there are some risk factors that make a woman more likely to have a placental abruption. Some of those risk factors include:

High Blood Pressure/Pre-Ecclampsia (most common)
Women over 35
Women with a history of placental abruption
Cocaine users
Diabetics
History of twins or multiple births
Women with more than 4 children

The outcome depends on how much of a separation she has and what her history is like. I would very much like it if you were to follow up with me to let me know how she is doing, whether this is a partial or full separation and any more information you might think of t hat may help me to answer you more definitively. I wish her the best of luck, please feel free to follow up with me at any time.