Placental abruption: symptoms and treatment
Detachment of the placenta is a pathological condition that occurs in the first or last trimester of pregnancy and represents a serious danger to the life of the child and mother. The placenta is an organ by which nutrients and oxygen from the mother’s blood are supplied to the fetus. In addition, thanks to the placenta, the products of the vital activity of the fetus enter the mother’s bloodstream and are removed from the body. That is, the placenta fulfills the transport function and contributes to the provision of the vital activity of the fetus in the womb of the mother. Therefore, the detachment can cause serious disruptions in the life of the fetus and even cause death of the fetus and the mother.
To understand why premature detachment of the placenta is so dangerous, it is necessary to understand the physiology of women during pregnancy. The placenta in the body of a pregnant woman acts as a depot of useful substances necessary for normal growth and development of the fetus. It develops until the end of the second trimester, and after birth the doctor carefully examines it, which allows to identify various possible anomalies in the development of the fetus.
Thus, since this body performs an important function to provide the fetus with useful substances and oxygen, premature detachment of the placenta leads to anomalies in the development of the fetus and its death. Also, with such a pathology, there is a possibility of death of a future mother, since premature detachment leads to the development of severe blood loss, especially during the third trimester.
If placental abruption occurs in the first trimester, minor bleeding is observed, not life-threatening women, but capable of leading to fetal death. When this pathology occurs in the third trimester, the probability of maternal and fetal death without timely treatment is very high.
The causes of this violation are external and internal. For external reasons, one can include smoking a woman in position. Despite the fact that doctors warn all women about the dangers of smoking, many of the fair sex can not get rid of the addiction and continue to poison their body, which causes the appearance of a pathology such as placental abruption.
It is also possible to cause this pathological condition dull belly trauma received by a woman during pregnancy, an act of violence committed over her at the time she is in the position, as well as a strong physical impact arising from car accidents and other emergencies.
Usually, when exposed to external factors on the woman’s body, in the first hours the detachment is insignificant, and does not threaten the life of the woman and the fetus in her womb. However, after a while, there is extensive bleeding, which can cause severe consequences — from preterm birth to death of the fetus, and even the death of the mother.
Premature abruption of the placenta has internal causes. In the first place among these reasons is hypertension of pregnant women — increased pressure inside the vessels leads to the development of this disorder, and bleeding occurs.
Also, the reason for the development of such a pathological condition can be multiple pregnancies and frequent childbirth — because of this the structure of the mucous organ changes, which impedes the full attachment of the placenta.
In women after second caesarean section, premature placental abruption is observed in 60% of cases. And still cause this pathological condition can pyelonephritis and infectious pathologies of the urinary tract. The risk of detachment of the placenta is very high in the case when twins are born. And although such a condition does not threaten the life of the child, it can cause severe blood loss, which will lead to the death of the mother.
Sometimes a premature detachment of a normally located placenta is due to the fragility of the capillaries. This is due to the development of gestosis in the body of a pregnant woman, therefore it is extremely important to be on time in order for the doctor to closely monitor the patient’s health.
In autoimmune diseases, premature detachment of the placenta can also occur. And this state can arise both at early and late dates. And one of the reasons for this disorder is an allergic reaction to the taking of some medications prescribed for women during the period of gestation.
Note that detachment of the placenta can occur both during the gestation of the baby, and during childbirth. The emergence of this pathological condition during childbirth is not so dangerous for the child as for the mother herself, because the large blood loss that characterizes this condition, can lead to the death of the mother.
A partial placental abruption usually occurs in the first trimester, and is amenable to drug therapy. Therefore, timely detection of this pathology can save the life of the future baby and his mother.
The most important signs of placental abruption are the occurrence of bleeding and pain in the uterus. Bleeding can be visible and hidden, that is, a woman can see blood on her underwear or not (but will feel pain in the uterus).
With external bleeding, brown, masticious discharge usually occurs, and with internal bleeding, the blood between the walls of the uterus and the placenta accumulates without secreting from the vagina. However, with internal bleeding, there is stress in the uterus, as well as severe pain.
In the fetus, with a pathology such as premature placental abruption, there is a disruption in the functioning of the heart, which can be detected during examination. Heavy oxygen deficiency of the fetus develops when one-third of the placenta has peeled off — this threatens not only the life of the child, but also the life of the mother.
Symptoms of this pathological condition can be not expressed and significantly expressed — it all depends on the time at which the abruption of the placenta occurred, and also on the degree of detachment. The more the placenta has peeled off, the more intense the symptoms, and the worse the prognosis of the course of the pathology.
If a premature detachment of the placenta occurred early in pregnancy, timely treatment can eliminate the problem, and later the pregnancy proceeds without complications. If the pathology has not been detected in time, then serious complications that threaten the fetus and the mother are possible.
The consequences of such a pathological condition can be different. Sometimes there are premature births, and the baby is born prematurely, sometimes a miscarriage occurs, but most often the fetus dies, and a pregnant woman may die.
The diagnosis of such a pathology as premature detachment of the placenta is carried out on the basis of the presence of clinical manifestations, in the form of bleeding and pain in the lower abdomen. At the same time, an ultrasound is required to confirm the diagnosis.
When ultrasound can be diagnosed:
- placental abruption in a specific area (partial), which can be eliminated by taking certain drugs
- total, when premature birth is required;
- Progressive total, which requires large-scale measures that make treatment effective.
This pathology needs timely treatment — the woman is urgently hospitalized and either causes premature birth if the detachment occurred at a period of more than 27 weeks, or prescribes medication to prevent the development of complications.
Conservative treatment is based on the intake of drugs that stop bleeding. Also, treatment involves taking antispasmodics and appointing a woman to bed rest. As a result of such treatment, a clot forms in the place of the placenta detachment, which does not affect the further development of the fetus.
In cases where placental abruption occurs in the second trimester (and this happens very rarely), the fetus exhibits disruption of the CNS, so only a woman can decide whether to leave the child or not. If the pathology develops in the third trimester, then it is an indication for an emergency cesarean section.
If you do not take measures and do not carry out proper treatment, the consequences of this pathology can be deplorable, so it is so important to be on time to register and regularly undergo a survey.