Pregnancy and the birth of a child is the happiest time in the life of every woman, despite all the problems of a difficult period of this physiological state. Even if the pregnancy proceeds without unnecessary worries, every woman, including a woman who has repeatedly given birth, still worries about how the birth of her child will go. With all the skill of obstetrician-gynecologists, in the most equipped clinic, unexpected complications can occur during childbirth. For example, the delay of the placenta. What is this complication and what causes it?
What is a placenta?
During pregnancy, a placenta is formed from the tissues of the fetus in the woman's uterus, or, as this formation is also called, "a child's place". The process of its formation occurs in the first three months of pregnancy. In the diagram above, it can be seen that one side of the child's place is attached to the wall of the uterus, then it passes into the umbilical cord that connects the fetus to the mother. The placenta grows with the fetus, and only at 36 weeks of gestation, growthit stops. It becomes the so-called "mature" placenta.
Basic functions of the placenta
So, let's consider what a temporarily formed organ does, which is inherent in absolutely all mammals, which include humans:
- transportation of useful substances from the mother's body to the fetus;
- excretion of fetal waste products;
- gas exchange (oxygen from the mother to the fetus, carbon dioxide from the fetus to the mother);
- synthesis of many hormones;
- barrier to harmful substances and pathogens.
What is afterbirth?
The afterbirth is the placenta with the membranes of the fetus and the umbilical cord. So the complete identification of the two concepts: "placenta" and "afterbirth" is not entirely true. Such a merger of concepts is explained simply: the successful exit of the placenta directly depends on how well the child's place separates from the uterine wall. The afterbirth comes out after the birth of the child (in fact, this is clear from the name itself). This happens in the third period of labor activity.
The afterbirth: the process of expulsion from the uterus
A woman's labor activity occurs in three stages.
First stage: smoothing and opening of the cervical canal of the uterus. That is, the uterus must open enough to expel the fetus from its cavity. This is about 10 centimeters, or, as the midwives used to say, five transverse fingers.
The second stage is the birth of a child.
And then comes the third, final stage:detachment of the fetal membranes and the child's place from the uterine walls and the birth of the placenta. This happens as follows: in the period of 30 minutes after the birth of a child, the uterus begins to contract again in a woman in labor. The placenta, which does not have muscle fibers, and therefore does not contract, begins to separate from the place where it was attached. After separation from the uterus, the placenta is expelled. This is normal. But a complication is possible when the placenta does not completely exfoliate or does not separate at all.
Why doesn't the placenta separate?
There may be several reasons for this:
- decreased strength of uterine contractions;
- tightly attaching a child seat to the wall;
- increment to the wall, up to the penetration of placental tissues into the deep layers of the uterus (the most formidable pathology);
- wrong structure (too thin or having two lobes placenta);
- location of the placenta in the lower uterus;
- location in the area of the myoma node.
What do they do if the last one doesn't come out?
If the doctor has determined the development of such a complication as non-discharge of the placenta, a number of measures are taken to stimulate uterine contractions. The first thing an obstetrician-gynecologist advises to do is to massage the nipples. As a rule, this simple procedure helps to expel the afterbirth. It did not help? Then, in order to stimulate contractions, bladder catheterization is performed and drugs are administered. In the absence of the results of the measures taken, after 30 minutes, the last is manually separated. This event is heldunder anesthesia. If a placenta that has grown into the thickness of the uterine wall is suspected, the woman in labor is prepared for the prompt removal of the placenta.
Complications
As a rule, they are dangerous precisely because of their rapid development and unpredictability
- Bleeding. It can be a formidable complication if it is strong and massive, as it can lead to shock and even death.
- Postpartum may develop endometritis.
- Blood poisoning (sepsis).
Reason for delayed afterbirth
Why doesn't the afterbirth come out? This can be due to a number of he alth problems that the woman in labor acquired before pregnancy:
- dystrophic changes in the uterus, scars after surgical interventions;
- inflammation of the mucous layer of the uterus;
- frequent scraping of the uterine mucosa.
Prevention
Disturbances in the birth of the placenta can be avoided if the following rules are followed:
- You should prepare for pregnancy, plan it, taking into account the state of he alth, domestic factors and psycho-emotional state.
- Prevent infectious and inflammatory diseases of the genitourinary system and pelvic organs: exclude casual sex, use condoms during sexual intercourse, observe the rules of intimate hygiene.
- Treat diseases in a timely manner.
- When pregnant, find an experienced and responsible doctor whom you can trust in a timely manner; register (up to 12 weeks of pregnancy).
- Visit monthlyantenatal clinic: once a month in the first three months, at least once every three weeks in the second, and once a week in the last trimesters of pregnancy.
- Proper nutrition during pregnancy (eating fiber-rich foods, avoiding spicy, fatty, s alty foods.
- Daytime routine: getting enough sleep is essential.
- Compliance with the recommendations and instructions of your gynecologist.
- Quitting bad habits and drinking alcohol.
- Adequate exercise, exercise for pregnant women.
Optimistic
Forewarned is forearmed. Of course, the delay in the placenta is not a pleasant complication. But in the case of an attentive attitude to your he alth and to the he alth of your future little miracle, following all the recommendations of the doctor who monitors your pregnancy, the birth will certainly go well. After all, such an unpleasant complication as placenta accreta to the uterus, which can lead to surgical intervention, according to statistics, is very rare: 1 case per 24 thousand women in labor.
He alth to you and your children.
