The placenta is a very important organ that initially develops from the same cells as the baby itself. Until 11-16 weeks, it is called the chorion, the villous membrane of the embryo: its villi penetrate the thickness of the uterine wall, oxygen and nutrition enter the baby through them, and its waste products and carbon dioxide are removed. After this period, a full-fledged placenta is formed, which also has many villi, but, in addition to nutrition, also produces hormones (in particular, progesterone) that help maintain pregnancy (before the formation of the placenta, this function is performed by the corpus luteum in the ovary).
The placenta does not have a contractile function, but is attached to the uterus - a strong and large muscle, which even before the onset of childbirth periodically “trains” for a short time, which is expressed in the reduction of its individual sections for a short period of time. Usually the placenta adjusts to thesemovement, and nothing happens to it, but sometimes a situation arises when a larger or smaller section of it exfoliates from the wall of the uterus. Then the fetus suffers, as its nutrition is disturbed. In addition, this condition can lead to death of the mother and fetus, so the symptoms of placental abruption should be brought to the attention of both pregnant women and their families.
What is placental abruption?
Normally, the placenta should attach closer to the top, that is, the bottom of the uterus, usually along its back wall, but sometimes it is located closer to the exit - the cervical canal. This is called placenta previa. It can be full or central, when the child's place is located on both sides of the exit from the uterus, blocking the exit from it. It may also be that the placenta is simply a little lower than it should be. Such placentation is a factor predisposing to detachment.
Thus, a normally located or placenta previa can exfoliate. How exactly it is located depends on the symptoms of placental abruption.
Also, manifestations will depend on such factors:
- detachment continues or she was able to stop;
- where did it separate from the wall of the uterus - in the center or on the edge;
- at what time of pregnancy or even childbirth did such a condition develop: placental abruption in the early stages, if a very small section of it has moved away from the uterine wall, it has a mild course and a favorable prognosis, since subsequently the child's place will still grow and develop, and it is likely that the defect will close and "outgrow".
What are the symptoms of placental abruption?
Three signs are considered basic:
1) Vaginal bleeding of varying intensity.
2) Pain in the abdomen, its lower sections.
3) Signs of fetal suffering: change in heart rate, increase or decrease in its motor activity.
Symptoms of placental abruption, depending on the clinical situation, are as follows:
I. If placenta previa abruption occurs on the edge, there is mainly only bleeding, there is almost no pain. If such a small area exfoliated, the fetus does not suffer.
II. If the placenta, wherever it is located, exfoliates in the central area, and the bleeding stops (that is, the detachment is non-progressive), then there may be no symptoms. A woman finds out about this case on an ultrasound or later, after the fact, a little brown blood is released.
III. If detachment of a normally located placenta in the marginal segment exfoliates, two of the three symptoms may be present: bleeding and pain. If the bleeding does not stop, then the fetus begins to suffer, contractions and premature birth (or miscarriage, if it is placental abruption in the first trimester) may begin.
IV. When the detachment of the central part of the placenta occurs, blood accumulates behind the placenta. This is called retroplacental hematoma. She's on her own, even if the bleeding has stoppedable to exfoliate the placenta further. As a result, a significant area, and even the whole placenta, can exfoliate. Blood with such a partial detachment is not always released to the outside. Then the symptoms of placental abruption are as follows: weakness, pallor, palpitations of the woman, she feels pain in the abdomen, uterine tension, the baby first moves more often, then it can calm down altogether. With further impregnation of the walls of the uterus with blood from the hematoma, the pain intensifies, the uterus does not relax. If the blood finds a way out, it pours out of the vagina.
V. The placenta can exfoliate during childbirth. Then bleeding also occurs, clots may be released. The uterus does not relax well outside of contractions, if the fetus suffers, then its dark feces - meconium - are excreted. These signs should be noted by obstetrician-gynecologists
What to do if you think you have a detached placenta?
For any blood discharge during pregnancy, even if it is a brown "daub", you must take a horizontal position and inform your gynecologist who is observing you. If scarlet blood is released, you need to lie down immediately, do not even get up to go to the toilet, be sure to call an ambulance and ensure yourself maximum peace. If the child (according to ultrasound) developed normally, you do not have severe gestosis or chronic pathology, there is a high probability that you will stop the bleeding with the strictest bed rest, and then help will arrive in time. Stopping bleeding in case of placental abruption does not mean that you can get up, for several days you will even have to go to the toilet while lying on the ship.
