Q. I had a placenta abruption with my first child. What are the odds that it will happen again and is there anything that I could do to prevent it? Are there any signs that I may look for? Currently I am in my 5th month and am having lower back, lower abdominal, and lower belly pain. Is this something that could be related to my placenta starting to separate?

A. The placenta develops with pregnancy to bring oxygen and nutrients to the developing fetus, and remove waste products from the fetus. The placenta is firmly attached to the uterus, but if this attachment is faulty the condition is known as "abruptio placenta or placental abruption". It can cause significant blood loss and is a serious risk for the baby and the mother. The condition most often occurs in the third trimester.

Fortunately is only occurs in 1 % or fewer of pregnancies. The risk is estimated to be 4 % if abruptio has occurred in a previous pregnancy. Risk factors for the condition include hypertension (either preceding or during pregnancy), prior uterine problems such as fibroids,smoking, and excessive alcohol or other drug use during pregnancy, and other factors. No single test is highly accurate for monitoring an abruptio, so frequent contact with your doctor is advised.

http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm

http://www.nursingceu.com/NCEU/courses/placentanc/

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