Detachment of a normally located placenta is considered one of the most difficult conditions that occur during pregnancy. With this pathology, the danger threatens both the woman and her child. The most severe consequences occur with placental abruption on later dates pregnancy.

Causes of placental abruption

Without the placenta, the child simply could not exist in the womb for all nine months. It is the fetal place that guarantees the supply of oxygen, nutrients and vitamins to the baby. In the event that the placenta for some reason does not cope with its functions, they speak of its insufficiency. In more severe situations, the fetal place may even move away from the uterine wall and lead to the death of the fetus.

Under normal conditions, the placenta is born immediately after the birth of the child. It happens that the placenta exfoliates much earlier than the due date. In the second half of pregnancy, the following factors lead to the occurrence of this pathology:

• severe gestosis;
• kidney disease;
• exacerbation of chronic diseases of the heart and large vessels;
• disorders in the blood coagulation system (thrombophilic complications);
• significant shocks and stresses;
• multiple pregnancy.

Hormonal and infectious factors that were given importance on early dates, in the second half of pregnancy fade into the background. After 20 weeks, the main cause of placental abruption is the pathology of hemostasis. Diseases are of great importance of cardio-vascular system especially in women over 30 years of age.

Symptoms of placental abruption in late pregnancy

The main sign by which one can suspect the departure of the fetal site from the walls of the uterus is bleeding. The intensity of bleeding from the genital tract will depend on the size of the detachment. With partial discharge of the placenta, the discharge will be moderate and even meager. In late pregnancy, this phenomenon occurs quite rarely. Where as more often there is a complete detachment of the placenta with massive bleeding. This development of events threatens the life of the woman and the fetus and requires the immediate help of specialists.

It happens that the placenta moves away from the uterine wall, but bleeding does not develop. An extensive hematoma is formed between the fetal site and the uterus, the blood from which gradually seeps into the muscular and serous layers of the organ. If more than 1/3 of the placenta is damaged, the fetus dies. The only sign of placental abruption in this situation will be the absence of fetal movements for a long time.

How to guess that something is wrong with the baby? A woman feels the first movements at a period of 16-20 weeks. At first, these are timid, barely noticeable tremors every few days. The baby is growing up, and the movements of the fetus are becoming more active. By the end of pregnancy, the baby kicks the mother's tummy several times a day. Over time, every woman notes that the crumbs have their own periods of activity. It has been observed that some children move more in the morning, while others prefer to stay awake at night.

If there are any deviations from the usual movements of the fetus, you should consult a doctor. A decrease or increase in the activity of the child does not always indicate placental abruption. This may be a sign of hypoxia, and in this way the baby signals to his mother that he is not feeling well. The absence of fetal movements during the day after 30 weeks is an alarming sign and can be regarded as a symptom of placental abruption.

Additional diagnostic methods

If a detachment is suspected, all women must undergo an ultrasound examination. During the procedure, the fetal heartbeats are counted. The thickness of the placenta, the presence of calcifications and other changes in it are also evaluated. When a hematoma is detected, its dimensions are measured.

After 34 weeks, cardiotocography (CTG) is performed. This method allows you to determine the number of fetal heartbeats per minute, as well as evaluate their rhythm. At the same time, the state of the muscular layer of the uterus is monitored. The appearance of large Braxton-Hicks waves indicates that the uterus is in an increased tone and is ready to get rid of the fetus at any time.

What threatens placental abruption to a woman?

With partial detachment of the placenta, anemia develops. In the blood, the level of red blood cells falls, which inevitably leads to a decrease in the amount of iron. All these processes threaten to lead to a lack of oxygen, which negatively affects the condition of the child. Anemia during pregnancy can be a direct cause of fetal hypoxia.

In late pregnancy, the discharge of the fetal site ahead of time leads to the development of heavy bleeding. In severe cases, hemorrhagic shock develops. The woman is losing consciousness, and only a team of experienced resuscitators can help her.

Against the background of severe blood loss, DIC often occurs. At this point, mechanisms are launched that prevent normal blood clotting. Disseminated intravascular coagulation leads to the appearance of new episodes of bleeding, which will be difficult to stop.

What threatens placental abruption to the fetus?

The placenta is an important organ that connects the baby to the mother's body. With partial placental abruption, the supply of oxygen and nutrients to the baby is limited. Fetal hypoxia develops, which inevitably affects its development. The lack of oxygen primarily affects the brain, but the rest internal organs experience the effects of hypoxia. Partial abruption of the placenta almost always leads to the development placental insufficiency and the birth of a child with various developmental pathologies.

Departure of more than 1/3 of the fetal site leads to the death of the fetus. The supply of oxygen to the baby stops instantly, and the further existence of the child in the womb is impossible. You can save the baby only when performing a caesarean section as soon as possible.

A child born after 22 weeks is provided with all the necessary resuscitation measures. Immediately after birth, the baby falls into the hands of neonatologists. Premature newborn transferred to a specialized department, where he will be cared for by specially trained personnel. As soon as the child adapts to the new conditions of existence, he will be discharged home.

Management of placental abruption in late pregnancy

Preserving therapy is carried out only with partial detachment of the placenta. If the fetal heart beats, doctors try to extend the pregnancy to at least 36 weeks. For this purpose, drugs are prescribed that improve uteroplacental blood flow. Currently, actovegin and its analogues are very popular. The drug is administered intravenously by drip in a course of 5 to 10 days.

In late pregnancy, placental abruption is often associated with pathology of the blood coagulation system. That is why many expectant mothers are prescribed antiplatelet agents. Pentoxifylline and other similar drugs act on platelets, reducing their activity. Antiplatelet agents thin the blood, reduce vasospasm and improve microcirculation in tissues. The course of therapy lasts from 7 to 10 days.

With complete abruption of the placenta, an emergency cesarean section . The duration of pregnancy does not play a role here, we are talking about saving the life of a woman and a child. During the procedure, the vessels are sutured and the bleeding stops. After the operation, the woman is in the intensive care unit for several days. Premature babies are transferred to a specialized department, while babies born after 36 weeks stay close to their mother.

Placental abruption can occur not only during pregnancy, but also during childbirth. This often happens at the birth of the first child from twins, as well as in the case of abnormal labor activity. In this situation, tactics will depend on how far the baby has managed to advance. If the child is already at the very exit, he is helped to be born with the help of obstetric forceps. In all other cases, an emergency caesarean section is performed.

The placenta is the tissue surrounding the fetus, designed to exchange nutrients between mother and fetus. The condition when the placenta before childbirth exfoliates from the inner wall of the uterus, partially or completely, is commonly called premature detachment of the placenta. Placental abruption can cause hypoxia of the child (oxygen starvation) and cause heavy bleeding in a pregnant woman.

If you do not provide emergency medical care to a pregnant woman, then there is a real threat to life.

Symptoms

Most often, placental abruption occurs during the last 12 weeks before delivery. The classic symptoms of this condition are as follows:

Profuse bleeding;

Abdominal pain;

Backache;

Frequent spasms of the uterus (more than one spasm in 3 minutes).

Pain in the abdomen and back begins suddenly. Then the bleeding starts. The more the placenta is exfoliated, the more bleeding will be.

In some cases, the placenta may exfoliate slowly.

If you have at least one symptom, you urgently need to contact your doctor.

Causes of placental abruption

Very often, the cause of placental abruption cannot be established. I can only list the most common factors that increase the risk of developing this condition:

a history of placental abruption (if you had a placental abruption during a previous pregnancy);

High blood pressure (hypertension disease or the development of late toxicosis during pregnancy);

Abdominal injury (one of the most common causes);

Smoking and drug use;

Premature rupture of the fetal (amniotic) membrane;

Decreased blood clotting in a pregnant woman;

The age of pregnancy is over 40 years.

Complications

Placental abruption can cause life-threatening problems for both mother and baby.

A pregnant woman may have the following complications:

Shock due to blood loss;

Violation of blood clotting;

excessive blood loss;

Failure of the kidneys or other organs.

For a child, placental abruption can lead to the following consequences:

hypoxia;

Nutrient deficiencies;

premature birth;

Stillbirth.

What to do in case of placental abruption

Placental abruption requires urgent medical attention, so you are unlikely to be able to prepare for this problem in advance. However, try to follow these guidelines:

Keep track of any symptoms you experience and be sure to tell your doctor if there are any changes in your condition;

Tell your doctor about intolerance to any pharmacological drugs, if any;

If you smoked during pregnancy or used drugs, be sure to tell your doctor;

Ask the father of the child or someone close to you at this moment.

It is also advisable to ask the doctor some questions, the answers to which can calm you down:

What diagnostic procedures do I need to undergo?

Is there a real threat to me and my child?

What are the treatment options?

Do I need to be on bed rest?

What are the possible complications for me and my child?

Do I need a blood transfusion?

If you have any other questions for the doctor, feel free to ask.

Diagnostics

If there is a suspicion of premature detachment of the placenta, the doctor first of all conducts a gynecological examination. To determine the exact cause of bleeding, it may be necessary to perform ultrasound(ultrasound) and laboratory blood test.

Treatment

Treatment options will depend on the following circumstances:

- Pregnancy up to 34 weeks. If placental abruption is partial, hospitalization may be required. In some severe cases, doctors have to induce premature birth.

- Pregnancy over 34 weeks. Hospitalization is possible. If the detachment progresses, as a rule, a caesarean section is performed.

Prevention

Unfortunately, there is no specific prevention of placental abruption. However, you can reduce your risk of developing this condition by:

Do not smoke or use drugs during pregnancy;

If you have high pressure take medication prescribed by your doctor;

If you had a placental abruption during a previous pregnancy, be sure to tell your doctor about it so that he can monitor your condition more carefully.

Premature detachment of the placenta during pregnancy is a very serious diagnosis, which, depending on the degree of complexity and without proper treatment, can lead to. If this problem is observed at the edges, then the blood will penetrate between the membranes of the uterus and the wall - this bleeding is called "external". Signs of "internal" bleeding have more pronounced symptoms: blood begins to saturate the uterine wall and, thus, exfoliates the muscle fibers, forming a hematoma, after which the uterus takes on a peculiar shape and consistency. This pathology can be diagnosed with ultrasound at an early stage.

Placenta and its detachment

The placenta is a special connective tissue, similar to a large cake, which directly connects the mother and her baby. It is with the help of the placenta that the baby receives all the nutrients and oxygen it needs. If the placenta does not function normally, then the life and development of the child in the womb is impossible.

Placental abruption is called its premature separation from the uterine wall, which disrupts the normal function of this organ up to complete cessation. Placental abruption can happen at different stages of pregnancy: in the first weeks or immediately before childbirth. Moreover, if placental abruption occurred before the 20th week of pregnancy, then the chance to endure and give birth to a normal healthy child is much higher than if this happens at a later date. The thing is that the placenta grows in the first half of pregnancy and there is a high probability that this organ can in some way compensate for part of the lost surface, in contact with the walls of the uterus.

According to statistics, premature detachment of the placenta is registered as one case in 120 pregnancies. Unfortunately, every sixth baby dies.

There are three degrees of placental abruption:

• First: with this pathology, the child does not suffer at all. If placental abruption is less than 1/3, then there is every chance to continue the pregnancy.
• Second: there is a risk for the baby to die from hypoxia. Detachment occurred halfway.
• Third: the child almost always dies. Complete detachment.

Experts call a partial detachment a "threat of miscarriage", and a complete one - a miscarriage.

Symptoms:

1. Bleeding from the genital tract (vaginal or uterine). In 80% of pregnant women with placental abruption, spotting from the vagina is observed, but bleeding can also be internal. If internal bleeding was not diagnosed in a timely manner, then the main task of physicians is to save the life of the mother, since the fetus (mostly dead by that time) is removed along with the uterus. This situation arises due to the fact that the placenta exfoliates in the center, the blood gradually fills the free space and gradually impregnates the wall of the uterus, as a result of which it loses its contractile abilities. This process was first described by Kuveler, so the state is named after him. External bleeding is usually not as heavy as internal bleeding, and if it is not secondary, then its appearance can contribute to the thrombus of damaged vessels, thereby preventing further complications.
2. Pain in the abdomen and This symptom is observed in 70% of cases of premature detachment of the placenta. Most patients describe the pain as dull, aching and radiating to the thigh or perineum. Especially severe pain happens with internal bleeding.
3. Violation of the cardiac activity of the fetus. As mentioned earlier, the fetus receives oxygen through the placenta, therefore, with detachment of 25% of the area, hypoxia develops in the fetus, the area of ​​detachment of 30% is already threatening, and 50% leads to its death.

These symptoms are classic and depending on the duration of pregnancy, they can manifest themselves in different ways.

So, in the early stages, this complication is accompanied by minor external bleeding and, with appropriate therapy, the pregnancy proceeds without complications in the future, and in the second trimester, increased uterine tone and the development of fetal hypoxia are added to the bleeding. Until the middle of the second trimester, they are monitored and, if necessary, treated, but if detachment occurs in the second half of pregnancy, then the question of premature delivery by caesarean section is raised. It is also worth noting that the clinical picture of placental abruption, in addition to the main symptoms, also has such manifestations as rapid breathing, anxiety, dizziness and faintness, as well as bouts of nausea and even vomiting.

Causes of premature placental abruption

Until now, experts still cannot name what are the causes of placental abruption. Previously, there was an opinion that a woman’s wrong lifestyle leads to this: for example, if she smokes, drinks or uses drugs, and also if her diet is not varied and future mom does not receive any vitamins, minerals and trace elements. But there is no scientific evidence that this is actually the case. However, scientists have good reason to believe that vascular problems, for example, late preeclampsia or arterial hypertension, lead to this defect. Often, placental abruption is a consequence of a stroke, for example, when a woman receives an abdominal injury. Sometimes there is placental abruption with polyhydramnios and with multiple pregnancy- immediately before childbirth or in childbirth. Doctors say that in this case, the cause of detachment is a sharp decrease in intrauterine pressure. By the way, not only their pathology can lead to the transformation of blood vessels, but also various ailments, such as hypovitaminosis or nephritis.

First of all, a woman who feels nausea and dizziness, which are accompanied by abdominal pain, vomiting, rapid pulse and pale skin, should suspect a serious illness and immediately go to the hospital for help.

Treatment and prognosis

• Treatment of this problem depends on the duration of pregnancy and the degree of pathology. At short term They try to save the child in every possible way, and the pregnancy is very conservative. With a full-term pregnancy, doctors can stimulate a woman, while if the detachment is small, then the pregnant woman can give birth herself. If the detachment is large, and it poses a threat to the life of the baby, then the woman must have a caesarean section. During childbirth, you need to open the bladder - this, most often, stops the exfoliation of the placenta, and also accelerates the emptying of the uterus - forceps are also used for this. In this case, the placenta must be removed manually, and the uterine cavity is carefully examined.
• Often, immediately after childbirth, a woman may begin bleeding due to the fact that there is insufficient uterine tone and there is a violation of blood clotting. If a large hemorrhage occurs in the uterus, then after a caesarean section, doctors do an amputation. That is, if the bleeding fails to stop, the uterus continues to contract, and blood transfusion and hemostatic therapy do not work, then doctors may even decide to remove the uterus.
• As for re-pregnancy, after placental abruption, experts advise getting pregnant no earlier than a year later. Just during this time, the uterus is able to fully recover after the operation, and the woman's body will again be ready for the birth of a new life inside. But, do not forget that doctors say that repeated pregnancy can proceed with the same complication, therefore, before it and during it, it is worth listening to the advice of doctors and fulfilling all their prescriptions.

Placental abruption is a serious diagnosis that complicates the course of pregnancy and directly threatens its favorable outcome. Is it possible to prevent this condition and what to do if detachment does occur?

The placenta is not in vain called the "children's place", because it is formed and functions solely in the interests of the unborn child. This unique organ appears in the body of a pregnant woman shortly after conception, and throughout pregnancy is the link between the mother and her unborn baby. The main tasks of the placenta include:

1. Providing the fetus with nutrition and oxygen. In fact, the placenta consists of a huge number of vessels intertwined with each other, through which the blood of the mother and the fetus she carries is constantly moving. It's from the mother's blood future child receives all the nutrition and oxygen it needs.
2. Removal of fetal waste products, which also occurs due to the close interaction of the blood vessels of the mother and child in the placenta.
3. Production of hormones. The placenta produces and releases into the mother's blood a huge amount of hormones that help maintain pregnancy and prepare a woman for childbirth and breastfeeding.
4. Protecting the fetus from unwanted influences environment. As the placenta forms, a hematoplacental barrier forms in it - a kind of filter, thanks to which many unnecessary and even harmful substances from the mother's blood do not enter the child's blood.

Important: Despite the presence of a hematoplacental barrier, the placenta is not able to protect the baby from the harmful effects of nicotine, alcohol-containing and narcotic substances, certain drugs and viruses .

What is placental abruption

Nature provides that the placenta should perform its functions of life support for the child until it is born. And only after the baby was born, the placenta spontaneously separates from the walls of the uterus and is born after it.

For a number of reasons, sometimes this algorithm fails, and the placenta separates from the walls of the uterus even before the birth of the child - in this case, we are talking about placental abruption.

Important: Untimely or premature placental abruption is diagnosed in about 1% of cases.

This pathology can overtake a future mother at any gestation period. But in late pregnancy, premature placental abruption is most dangerous, since the placenta at this time no longer grows and develops, which means that it will not be possible to compensate for the abruption in a natural way. Doctors have to save the child's life with an emergency caesarean section. Otherwise, the consequences can become unpredictable, even fatal.

Important: Placental abruption is the main cause of intrauterine death, as it leads to the rapid development of acute oxygen starvation in the fetus.

Why does placental abruption occur?

Scientists have not yet identified a single factor that would unequivocally lead to the occurrence of placental abruption in late pregnancy. But numerous studies have confirmed that the risk of developing this pathology increases in the following cases:

• high blood pressure for a future mother for a long time;
• injury to the abdomen of a pregnant woman (as a result of an accident, accident);
• diagnosed placental abruption in the past increases the likelihood of the same pathology up to 25%;
• uterine abnormalities (eg, saddle shape);
• anomalies of the placenta (previa, the presence of additional lobules);
• pathology of blood clotting in a pregnant woman;
• caesarean section in the past;
• multiple pregnancy;
• delayed pregnancy;
• polyhydramnios;
• a large number of births;
• rapid childbirth;
• the age of the pregnant woman is more than 34 years;
• early and late toxicosis;
• autoimmune and chronic endocrine diseases (lupus, diabetes mellitus).

Important: With a combination of 2 or more factors, the risk of developing placental abruption increases many times. Such women should be especially attentive to their health during pregnancy.

Detachment symptoms

Depending on where the detachment occurred and how extensive it is, the symptoms can be of varying severity. But the main signs of placental abruption in a pregnant woman in any case are:

• Uterine bleeding. It always occurs, since detachment is a break in the connection between the placenta and the wall of the uterus, which is accompanied by bloody discharge. Bleeding is external in most cases, and a pregnant woman can detect it almost immediately.

Important: If any bleeding from the vagina is detected, a pregnant woman should immediately consult a doctor.

In 20% of cases of placental abruption, there is no bleeding, since blood accumulates in the form of a hematoma between the placenta and the uterine wall. This is very dangerous state, since the growing hematoma presses on the placenta and thereby exacerbates its detachment. In this case, the main symptoms of the pathology will be

• Pain in the abdomen, its palpable tension. With internal bleeding, a hematoma occurs, which gradually increases in size and begins to put pressure on the wall of the uterus and peritoneum, irritating them and causing pain. If, at the same time, a pregnant woman also has a general malaise in the form of nausea, increasing weakness and dizziness, this is an alarming sign of possible internal bleeding. Contacting a doctor should be immediate!

On the part of the fetus, a symptom of placental abruption is a state of acute hypoxia or oxygen starvation. With a slight degree of hypoxia, the fetus begins to move actively. Thus, he, as it were, “massages” the placenta in order to increase the flow of oxygen and nutrients. As the degree of oxygen starvation increases, the child's movements become more and more rare, his cardiac activity is disturbed.

Important: If placental abruption is suspected, it is imperative to conduct a cardiotocographic study to assess the health of the fetus.

Detachment of the third part from the entire area of ​​​​the placenta can lead to the death of the baby. With complete detachment of the placenta, intrauterine death of the fetus occurs almost instantly.

Diagnosis of placental abruption

This diagnosis rarely causes difficulties for doctors, since most often there are bloody discharge from the genital tract of a pregnant woman, abdominal pain and increased uterine tone, and signs of oxygen starvation in the fetus.

Ultrasound diagnostics is necessary in order to classify placental abruption on the following grounds:

Basis for classification	Types of placental abruption	Forecast
Time of occurrence	Early (up to 20 weeks)	Favorable, 80% deliver on time
	Late term (after 20 weeks)	Unfavorable, term delivery in 20%
	During childbirth	Adverse
Progression	progressive	Adverse
	Non-progressive (detachment has stopped)	Favorable
Square	Partial	Favorable when the detachment area is less than 25%
	Complete	Adverse
Localization	Regional - the placenta is separated along the edge, uterine bleeding is pronounced	Favorable with a small area of ​​detachment
	Central - the placenta separates in the central part, uterine bleeding may be absent	Adverse
Severity	Mild - the symptoms are insignificant, there is no hypoxia on the part of the fetus	Favorable for the fetus
	Moderate to moderate maternal and fetal symptoms	Favorable
	Severe - the condition of the mother is severe, intrauterine death of the fetus	Adverse

Any spotting, abdominal pain, pronounced uterine tone, a significant deterioration in the well-being of a pregnant woman and a change in fetal activity should alert the expectant mother. If any of these symptoms occur, seek immediate medical attention medical care. Self-medication during pregnancy can be simply criminal, since it is not only about the health of the woman herself, but also about the life of her unborn child.

In late pregnancy, especially if there are only a few weeks left before the birth, the onset of placental abruption is a direct indication for emergency delivery. In this case, this is the optimal outcome for the mother and child in order to avoid irreversible consequences for their health.

If placental abruption is minor and non-progressive, then doctors will try to create all the conditions for a pregnant woman to deliver her baby. In this case, only inpatient treatment is necessary under day and night supervision of physicians in compliance with strict bed rest. Monitoring the child's condition is carried out using dopplerometry and cardiotocography. Any negative changes in the condition of the mother or fetus may be an indication for an emergency caesarean section.

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placenta plays important role in fetal development. Through it, the baby eats and breathes, so deviations from the norm are dangerous at any stage. If the expectant mother suddenly found placental abruption in the early stages of pregnancy, then prompt observation and intervention of specialists is required. The cost of delay may be the life of the baby.

After the conception of a child, a fertilized egg begins to form. It is fixed on the wall of the uterus and continuously grows. At this stage, the chorion appears. These are villi that tear the surface of the fetus. Small vessels pass through the outgrowths of the chorion, with the help of which penetration into the inner membrane of the uterus and fixation in it occurs. The chorionic villi are immersed in blood from the outside. Such a system allows the fetus to receive oxygen, nutrients, and in return to give carbon dioxide and waste products.

The placenta for a child is the lungs, kidneys, digestive organs, skin. The consequence of detachment of the chorion in the early stages of pregnancy may be a miscarriage, therefore, it is impossible to do without surgical intervention.

Life cycle of a children's place

The placenta forms during the first 12 weeks of pregnancy. What follows is continuous growth. By 34 weeks, the baby's place reaches its maximum size and begins to age. This is a natural process in which 4 stages can be distinguished:

• lasts up to 27-30 weeks;
• active growth from 27-34 weeks;
• maturity period, which covers 34-39 weeks;
• aging from 37 weeks to childbirth.

Violation of the stages of aging

Sometimes the aging of the placenta occurs prematurely. It can be caused by the characteristics of the woman's body or a number of pathologies:

• the second half of the term;
• toxic substances and medicines;
• uterine injury;
• multiple pregnancy;
• , drugs;
• chronic diseases;
• malnutrition or diet;
• and consequences of previous difficult births;
• infections in the uterine cavity.

Early maturation of the placenta during pregnancy leads to oxygen starvation of the fetus and a lack of nutrients. He can lose weight, develop abnormally and be born unhealthy. To avoid serious consequences, you need to be regularly observed by a doctor, undergo a course of treatment.

What is a detachment?

Detachment of a child's place is its separation from the inner surface of the uterus. It may be partial or complete. The resulting void is filled with blood, which further repels the chorion. The process of separation should occur in childbirth, but it can also be premature. Chorionic detachment in early pregnancy is dangerous for the baby, because it can leave him without oxygen and useful nutrients.

Degrees of detachment of the child's place:

• The discharge area is less than 1/3, which does not harm the child, can be compensated for by his growth. Pregnancy is saved and continued.
• Detachment by half can lead the fetus to death from oxygen starvation.
• Full. Almost always carries the death of the baby.

The latter ends, and the first two are attributed to the threat of spontaneous abortion.

Why is the chorion rejected?

According to statistics, 0.4-1.4% of pregnant women face the problem of premature rejection of a child's place. This can happen in the first or second birth period, but most often the latter poses the greatest danger. Among the causes of placental abruption in early pregnancy are:

• woman's age;
• the presence of harmful addictions;
• a large number of births;
• malnutrition;
• infection or inflammation in the uterus;
• chronic diseases;
• abdominal trauma;
• pathology of the uterus or placenta;
• preeclampsia;
• a long period of infertility before conception.

Symptoms of premature rejection

The main signs of placental abruption in early pregnancy:

• - can be external or internal. If separation occurs at the edges, then discharge appears from the vagina. Internal bleeding is more difficult to detect. It occurs with the central detachment of the child's place, when the edges remain attached, and fluid accumulates in the resulting space. An urgent surgical intervention is needed (sometimes with complete removal of the uterus). It will be about saving the mother. The fetus usually does not survive.
• Mild aching pain, provoked by increased. It may radiate to the groin area or thigh and be a clear sign of internal bleeding.
• Violation in the cardiac activity of the fetus. The condition will be affected by maternal blood loss and the amount of detachment. Insufficiency will appear already when 1/4 of the area of ​​\u200b\u200bthe child's place is discharged. Severe oxygen starvation occurs at 1/3 of the part, after which death may occur. If half of the placenta has passed, then the pregnancy will be impossible to maintain.
• Nausea, vomiting, dizziness, anxiety.

Identification and prompt elimination of the problem with placental abruption

A small detachment of the placenta in early pregnancy is not always accompanied by visible symptoms. It can be detected only with the help of timely diagnostics. It is important to regularly attend scheduled medical consultations.

Diagnosing the condition of the placenta

It is possible to diagnose placental rejection in early pregnancy during the procedure. This procedure allows you to identify retroplacental hematoma, accompanied by destroyed or oppressed tissues. In the early stages of a neoplasm, it may not yet be. Diagnosis is made by excluding diseases with similar symptoms. If the placenta is rejected, an ultrasound can detect blood clots behind it. The vagina can be carefully examined to exclude their damage, the presence of infections, tumors and other abnormalities.

Predictions for the departure of a child's place

This pathology is not uncommon. Prompt and qualified treatment can prevent its consequences. Timely detection of the problem and taking measures can stop the process and give a positive prognosis for the course of pregnancy in the future.

A small detachment of the placenta requires inpatient observation and treatment. The assistance provided will allow the child to develop normally. It is unacceptable to ignore any alarming symptoms during pregnancy. Departure of a child's place is a serious pathology. It can lead to irreparable consequences.

The issue of treating detachment of a child's place is not an easy task. Often you have to choose operative delivery. Additionally, blood clotting is monitored. It is important to deal with the shock state of a woman and replenish blood loss.

How is placental abruption treated?

The appointment of treatment for placental abruption in early pregnancy and beyond depends on various factors:

• the general condition of the woman and the child;
• trimester of pregnancy or childbirth;
• volume of blood loss.

Operative delivery can be replaced by treatment if:

• gestational age less than 36 weeks;
• a small area of ​​detachment and there is no progression of the process;
• cessation of discharges or small volumes;
• lack of signs of lack of oxygen for the child;
• well-being of the pregnant woman and hospital stay.

Doctors prescribe mandatory bed rest for the expectant mother, regular ultrasound, as well as dopleometry and cardiotocography. Her condition must be strictly controlled. Held laboratory research blood for clotting.

For treatment, antispasmodic drugs (,), hemostatic (Vikasol), anti-anemic (with a high concentration of iron) and aimed at relaxing the uterus can be used. In the presence of other diseases or complications, concomitant therapy is additionally prescribed.

Operative delivery may be prescribed if spotting begins to appear during observation in the hospital. This is a sign of the progress of placental abruption. In the later stages, an emergency caesarean section is most often used. But natural childbirth can also be stimulated. The decision is made based on the condition of the mother and baby.

Surgical intervention takes place under the continuous supervision of doctors over the state of the child's cardiac system. Natural childbirth will require a mandatory manual examination of the uterine cavity after their completion. At caesarean section, her condition is also assessed. If the muscle layer is saturated with blood, a complete removal of the uterus is necessary in order to avoid further bleeding.

Preventive measures for exfoliation of the placenta

There are no specific measures to prevent the pathology of a child's place today. This is due to the lack of confirmed causes of placental abruption in early pregnancy. Only a number of factors have been identified that may predispose a woman to the appearance of such disorders.

Prevention usually consists of:

• regular visits to the doctor and the passage of the required examinations;
• timely delivery of all tests;
• avoidance of stressful situations;
• good and;
• complete rest;
• healthy lifestyle;
• prevention of possible injuries;
• a sufficient number of walks in the air;
• control .

Taking any medication should be strictly prescribed by a doctor and only when absolutely necessary. Treatment of chronic diseases can be regarded as the prevention of the occurrence of complications and exfoliation of the child's place.

Subsequent pregnancies: will there be a recurrence?

For women who have had placental abruption in early pregnancy, there is a high probability of a recurrence of the situation in the future. About 25% of cases end the same way. Medicine cannot yet completely exclude the possibility of exfoliation of the child's place during subsequent pregnancies. However, you can try to prevent the repetition of violations on your own. To do this, it is worth adhering to the above preventive measures in order to minimize all risk factors.

Departure of a child's place is a serious and dangerous pathology for a pregnant woman and her child. Many women face it. It is important to seek help immediately if you experience any worrisome symptoms. If there is no threat to life and health, then the pregnancy will continue, but under closer control, most likely in a hospital. The progression of the pathology in the later stages will require operative delivery. According to the state of the mother and baby, stimulation of natural childbirth or caesarean section can be chosen. If you do not pay due attention to the exfoliation of the child's place, the consequences will be severe and irreversible. In the early stages, everything will end in a miscarriage.

Take care of yourself and your child! Don't neglect to see a doctor!