Placental abruption is a medical term that refers to a complication of pregnancy. Depending on a number of parameters, it leads to bleeding or spontaneous abortion. The consequences depend on the speed of contacting a doctor and the effectiveness of care. Therefore, it is important to know the alarming symptoms and respond appropriately to them. Today we’ll talk in detail about what constitutes placental abruption at different times and what it threatens.
Physiological characteristics
Today there is a lot of literature and courses for expectant mothers, which tell in detail how conception occurs and pregnancy proceeds. The specialist will definitely take the time and tell you what the placenta is. Let's start with female physiology.
Many believe that this is the inner lining of the uterus, orbag in which the child develops. This is not quite the correct definition. The placenta is a disc-shaped formation, that is, one of the sections of the fetal membrane. It attaches to the back of the uterus and provides a connecting function between the two organisms. Placental abruption threatens oxygen starvation and fetal death.
Timing of development
The formation of the placenta begins from the second week, when often a woman also has no idea that she is carrying a baby. However, this is only a germ that will fully develop and start working only by the end of the first trimester, approximately by the 12th week of pregnancy. It is at this time that the blood circulation of the expectant mother and child is completely demarcated. The placenta is a discoid formation. It separates the two organisms with a special membrane. It is logical to assume that placental abruption immediately disrupts the blood supply to the fetus, which is deadly for him.
Functions of the placenta
They follow logically from what was said above. First of all, it is a channel that allows the exchange of liquids and gases. From the mother, her tiny baby receives oxygen and nutrients for growth and development. At the same time, the mother's body takes back carbon dioxide. It is due to this that the embryo gets the opportunity to become a rosy-cheeked baby in a short nine months. But that's not all.
- The placenta simultaneously activates the production of hormones in a woman. It is important not only for normal growth and developmentbaby, but also to prepare the body for future changes.
- Performs a protective function, protecting the baby from infections due to maternal antibodies.
Seemingly perfect protection. You can not be afraid of anything and lead a normal life. But it's not. The barrier function of the placenta is conditional. Some of the harmful substances and toxins are blocked and excreted through the mother's liver and kidneys, but there are substances that pass the placental barrier. These include alcohol and nicotine, certain viruses and infections. Therefore, a woman needs to take care of herself, pay attention to the prevention of influenza and colds, and use medicines only after a doctor's prescription.
Dangerous Moments
At what time is placental abruption possible? This question is often asked by expectant mothers to doctors in order to focus on alarming signs during a certain period of pregnancy. And of course, breathe freely after its completion. Unfortunately, doctors cannot answer such a question. This is a complication that can occur at any time, at the very beginning of pregnancy, in the middle, or during childbirth. You do not need to set yourself up for bad things, but you need to be mentally prepared to immediately seek medical help.
I would like to add that the development of events, treatment and consequences will greatly depend on when exactly the detachment occurred, as well as on its scale (full or partial).
Main species
Detachment of the placenta in a pregnant woman every timekind of scenario. Therefore, doctors sometimes have to urgently diagnose and make the right conclusions. There are several types of detachment, so the symptoms can vary quite a lot. It is central, in which blood accumulates behind the placenta. In this case, there may be no external bleeding, which means that the diagnosis will be more difficult.
Marginal detachment always proceeds against the background of bleeding from the genital tract. This allows you to quickly understand that there is some kind of violation. However, it is less safe than the central one, as it progresses rapidly.
- When detached by a third, despite the real danger, all chances remain to endure the baby normally.
- If the detachment occurs halfway, then the woman needs urgent medical care. Otherwise, the child will die due to developing hypoxia. Moreover, doctors do not have much time.
- Complete detachment is a guaranteed death of the child. In this case, the primary task for doctors is to save the woman's life.
A long journey of a lifetime
The consequences of placental abruption will depend on when the development of this complication began. Accordingly, the symptoms also change. Today we will consider the features of development at each stage.
- First trimester. During this period, such a violation is not at all uncommon. If a woman is taken to the hospital on time, then in most cases it is possible to keep the pregnancy. Therefore, therapy is prescribed aimed at stopping bleeding and preservingpregnancy. If placental abruption in the early stages occurs for up to 12 weeks, then the woman feels pain and heaviness in the lower abdomen, notes bloody discharge from the vagina.
- Second trimester. Many believe that placental abruption in the early stages is the most dangerous. In fact, at this time, the placenta is in the process of growth and development, which allows you to compensate for the exfoliated area. Of course, only if it is less than half of its entire area. The symptoms of placental abruption can be added to the high tone of the uterus and its severe pain. But with a timely visit to the doctor, there is every chance to save the pregnancy. Only in the most severe cases, if the detachment is more than 50 percent of its area.
- As in the case of placental abruption in early pregnancy, in its final trimester and even at the time of childbirth, this complication is very dangerous and requires urgent examination and medical intervention. It is in the later stages that this happens most often, and the child is very difficult to tolerate this pathology. The placenta has already completed its growth, which means that there is no question of any compensation. But if the detachment is insignificant, then you can save the pregnancy. Otherwise, an emergency cesarean is performed.
What you need to know
The causes of placental abruption are still being studied. It is impossible to say for sure what a particular woman can lead to the development of such a complication. But there are major risk factors that not only doctors, but also every expectant mother should know.
- History of allergic and other autoimmune diseases. In this case, the body recognizes its own cells as foreign and tries to get rid of them. The causes of placental abruption in the early stages are often associated precisely with allergic diseases. Therefore, it is very important to inform the obstetrician-gynecologist at the first visit.
- Preeclampsia, which is characterized by severe edema, leads to a weakening of the walls of blood vessels. This affects the blood supply to the placenta and can lead to partial death.
- The causes of placental abruption in early pregnancy are often the bad habits of the expectant mother. If, by a later period, most women have already realized their responsibility, but in the first weeks, many continue to lead their usual way of life.
- Chronic diseases. This is especially true for diseases of the cardiovascular and genitourinary systems. The cause of placental abruption in the later stages is often pyelonephritis and preeclampsia.
- Serious abdominal injury.
- Severe infectious diseases.
Common signs
Depending on the duration of pregnancy, the clinical picture also changes. But there are also general signs with which you should immediately contact the local gynecologist or the nearest maternity hospital, or even better, call an ambulance.
- Bleeding. It can be visible or hidden. There is also mixed bleeding, when a small amount of blood is released from the vagina and morepart accumulates in the internal cavity. That is why doctors say that even if you notice a small blood stain on your underwear, you should see a doctor. Only a specialist can assess the condition of the mother and child.
- Pain and tension of the uterus. Also an alarming symptom, which can have many causes. In this case, the pain is dull. On palpation, they increase. The nature of the pain can be different, as well as its intensity. Therefore, it is not recommended to take no-shpu or other drugs to relieve the condition until you consult a doctor.
- Violation of the rhythm of cardiac activity in crumbs. At each appointment, the doctor must listen to the heartbeat. But you yourself can control his condition. Starting from the second trimester, the mother feels the movements of the crumbs. If the baby has become overly active or has calmed down for a long time, then you should definitely visit a doctor. He will listen to the heart of the crumbs and, if necessary, appoint a special examination.
Three degrees of pathology
Studying the causes and consequences of placental abruption, it should be noted that in any trimester this phenomenon may differ in severity and intensity of symptoms. Therefore, doctors conditionally distinguish three degrees:
- Easy shape. It is very difficult to notice on your own, because it is almost asymptomatic. Can only be detected by ultrasound.
- The medium form is characterized by pain in the lower abdomen and slight spotting.
- Heavy form. Severe, arching pains in the lower abdomen, dizziness up to fainting and a sharpweakness.
With a strong detachment, the woman's condition deteriorates sharply. Bleeding can be internal, but the pain will definitely make it clear that something is wrong in the body. Urgently call an ambulance, because the bill can go on for minutes. The priority is always the life of a woman, so if there is a question of choice, then doctors will choose the method of terminating the pregnancy. This leaves a chance to maintain the ability to conceive and bear, which means that she will be able to become a mother in the future.
Diagnostic Methods
Clinical signs are so obvious that no further testing is usually required. If the mother is able to answer questions, then an anamnesis is collected and conclusions are drawn based on this. Of the hardware methods, ultrasound is used. The doctor usually examines the vagina, as the cause of bleeding can be tumor processes. A blood test will be taken upon admission to the hospital, but it is better to immediately provide information about the blood type and Rh.
Correction methods
If the area of the lesion is small, then the fetus can be saved by resorting to the necessary drug therapy. The consequences of placental abruption in early pregnancy are often more serious, since the child will have to spend a long time in the mother's womb. Even if we are talking about a small area of its area, this will affect the supply of oxygen to the child. And as the fetus grows, the needs only increase.
To maintain pregnancy and the conditions for the normal development of the child, it is recommended to usethe following drug groups:
- Hemostatic and antispasmodics.
- Iron preparations.
- Progesterone preparations.
- Vitamin complexes.
The choice of drugs should be carried out by the attending physician, so we will limit ourselves to the description of the groups. The consequences of placental abruption in the early stages are most often reversible. But if this is repeated, or the area of the lesion is too large, then most often the death of the fetus follows.
Detachment of 1/3 of the placenta leads to fetal hypoxia, but still retains a chance to save him. But if this condition progresses, then doctors decide to perform curettage. Therefore, with placental abruption in the later stages, a caesarean section is often performed, which allows you to save the life of the baby.
What you need to be prepared for
This is a common anomaly. It can develop at any stage of pregnancy. Depending on the type of detachment, trimester of pregnancy, pathology can have a variety of consequences. Usually, a pregnancy specialist analyzes risk factors and, based on this, prescribes additional examinations.
In the most severe case, the death of the mother and child may occur. In a critical situation, doctors will try to save the life of a woman in the first place. Fortunately, today there is an ultrasound machine in every clinic, which allows you to monitor the condition of the woman and the development of the fetus. Therefore, it rarely comes to this. The second complication is the accumulation of blood directly in the uterus. Since atplacental abruption, a caesarean section is chosen as an obstetrics, the doctor will examine the uterus and decide whether to save or remove it. The second option is usually used if there is a high risk of developing neoplasms and hematoma growth. Of course, the woman remains barren.
The death rate of women due to placental abruption does not exceed 10% of all cases. Much more often this leads to a violation of the development of the baby, as well as his death. Moreover, in most cases, the fetus dies before the onset of childbirth, sometimes even before the start of the third trimester. It must be borne in mind that the detachment of any part of the placenta, even the most insignificant, affects the baby's body. In varying degrees, hypoxia develops. Lack of oxygen greatly affects the development of the brain. The larger the area of detachment, the more pronounced will be hypoxia and more serious bleeding. Therefore, even in the case of a happy outcome, that is, the birth of a living child, it is necessary to carefully monitor and correct its development.
Newborn assessment
Usually, it is at this moment that the doctor examines him and, using the Apgar scale, determines the consequences of placental abruption. This scale includes such signs as the activity of movements, the number of heartbeats per minute and other characteristics. The normal score is 8-10 points. If from 4 to 7, then this indicates moderate hypoxia. Low scores indicate that the newborn is in critical condition.
Oxygen plays a very important role in the development of the baby. In particular, the brain is completely dependent on the amountincoming oxygen. The slightest starvation takes its toll on him. The consequences of hypoxia are slow development, late mastery of speech and other basic skills.
Instead of a conclusion
Placental abruption is a very serious pathology of pregnancy. To date, doctors can already do a lot to predict and prevent this complication, as well as to carry out a correction. But a lot also depends on the women themselves. It is necessary to carefully monitor your well-being, drawing the attention of the doctor to any ailment. Especially if it is associated with pain in the lower abdomen or spotting. Only a specialist can conduct a competent diagnosis and take corrective measures. And the rest you need to eat right, walk a lot and worry less. Then the baby is more likely to be born he althy.
