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Premature detachment of the placenta is a complication of pregnancy that is dangerous to the health of the woman and the child. It involves the total or partial detachment of the placenta from the uterine wall when this detachment occurs after the 20th week of pregnancy and before the expected delivery date. Premature placenta detachment is the cause of more than 30% of vaginal bleeding during pregnancy. The placenta is a transitional fetal organ and appears in placental mammals. It is formed from the chorion and the uterine mucosa, called temporal. It is with the help of the placenta that the embryo takes oxygen and food from the mother’s blood and removes carbon dioxide and other waste products. The blood of the fetus does not mix with that of the mother, but through it, not only the nutrients necessary for the embryo’s development, but also viruses and antibiotics can penetrate the fetus.
Symptoms and diagnosis of placental abruption
Bearing it is a necessary and indispensable organ in the process of fetal development. When the bearing will come off early from the uterine wall, it is difficult to pass on to the unborn baby all the nutrients and oxygen. It causes disturbance of the development of the fetus and disturbs the pregnancy calendar. The most common symptom premature detachment of the placenta is the appearance of vaginal bleeding in the last weeks of pregnancy. Such bleeding is very often accompanied by pain, initially temporary, of the lower abdomen and rhythmic contractions. The abdomen can be hard and painful to apply pressure. Associated symptoms such as nausea and vomiting may also appear, especially in very severe cases. A tight uterus can make it difficult to examine the fetus.
When vaginal bleeding occurs, premature detachment of the placenta should always be the first suspicion. Vaginal bleeding is caused by a hematoma that occurs outside the placenta. It also happens that the blood changes the color of the amniotic fluid as it enters the amniotic sac. Premature detachment of the placenta it can also proceed without bleeding. If the placenta has come off completely from the uterine wall, and there is a coagulation disorder, vaginal bleeding may not occur. In each case, the physician examining the patient or managing the pregnancy should rule out other possible causes of uterine bleeding in the pregnant woman. It happens that pain similar to that that occurs with premature detachment of the placenta, is confused by pregnant women with pain associated with appendicitis, pancreatitis and peritoneal inflammation.
Diagnosis of a detached placenta is carried out mainly on the basis of an ultrasound examination, and the treatment is carried out only in hospitals in intensive gynecological supervision units, under the care and constant supervision of doctors. During the observation of the patient, her general health condition and the condition of the fetus are assessed by means of cardiotocography and ultrasound. Such care enables the prevention of hypovolemic shock, it also allows for systematic and multiple examination of the pregnant woman and constant monitoring of the condition of the fetus.
Separation of the placenta from the uterine wall is classified on a four-point scale, from 0 to 3. The factors influencing the classification are anatomical and clinical criteria, fetal heart abnormalities, shock, patient’s homeostasis, uterine tone, and the amount of blood lost. If premature detachment of the placenta from the uterine wall, it was asymptomatic, with no risk to the fetus and was diagnosed only after delivery, it is assessed as the lowest and assigned to 0. If only vaginal bleeding occurs, when it is not accompanied by any other symptoms, separation of the placenta classified as 1st degree. With an increase in uterine tone and the appearance of a threat to the health and life of the fetus, but bleeding does not have to occur, severity separation of the placenta it is classified as grade 2. The third and most dangerous degree of severity detachment of the placenta there is the onset of shock, coagulation failure, and fetal death. If the life and health of the pregnant woman or the fetus are at risk, doctors decide to terminate the pregnancy, especially in cases where the fetus is so developed that it is possible to survive outside the mother’s body. If the fetus is dead, doctors artificially induce labor. Caesarean section is performed only when childbirth is absent or as the method of choice in severe cases of threat to the patient’s life.
The causes of premature detachment of the placenta
Main reason premature detachment of the placenta there are disorders of the endometrium (endometrium) and myometrium (the muscular layer of the uterus) and disorders of the utero-placental circulation. Another reason may be the patient’s age. When the pregnant woman is over 30, she is at risk detachment of the placenta from the uterine wall is greater than in younger pregnant women. The causes are also deficiencies of folic acid, hypertension and defects in the structure of the uterus, as well as harmful not only to pregnant women, but also to all organisms, smoking, drinking alcohol and taking drugs. Premature detachment of the placenta It carries with it the possibility of various serious complications, which can even lead to the death of the mother or child. Other effects include hypovolemic shock, blood clotting disorders, uteroplacental stroke, damage to the maternal organs, and amniotic fluid embolism.