Placental abruption in early and late pregnancy. Symptoms, causes and consequences. What is it, what is dangerous by what is going on, symptoms, treatment

The successful course of pregnancy is possible only with the full functioning of the placenta, which ensures the normal development of the fetus. Normally, the placenta abruption must occur after birth, but in some cases, this pathology occurs early in pregnancy.

What is the placenta, its function during pregnancy

During pregnancy, it is formed and functions very important organ for the child gestation in the female body - the placenta. Its formation begins at the attachment of the embryo to the uterine wall. This body combines two of the circulatory system at the same time - the fetus and the expectant mother.

With a very complex structure plexus of blood vessels of the child and the mother, the placenta performs the following functions:

• Receipt of oxygen through the blood.
• Nutrient function - provides water saturation of the fetus, and useful nutrients, vitamins.
• Excretory function - takes part in the removal of waste products.
• The protective function - provides protection from the effects of adverse immunological factors, exercising mothers pass antibodies to the fetus.
• Hormone - forms a number of important hormones necessary for the regulation of metabolic processes. Development of placental hormones are not regulated by the mechanism of work of the endocrine glands.

On the part of the fetal placenta umbilical cord is connected, and through which performs all its functions. From maternal blood to the fetus receives oxygen and vital substances, and from child to mother carbon dioxide and products formed during metabolism.

The life cycle of child seats

Formation of the placenta begins with the attachment of the fetus to the uterine wall, and its rapid growth starting from 2 weeks of pregnancy. By 18 weeks the placenta reaches full development, in normal operation being fixed to the wall of the uterus with a smooth transition to the side.

For full gestation child seat should not reach the cervix closer than 7 cm, otherwise there is a danger presentation of the fetus.

Growth and placental maturation occurs throughout pregnancy and just before the birth of the child its volume starts to decrease gradually. Thus about half of pregnancy placenta growth rate significantly greater rate of growth of the embryo.

Body structure differs from the maternal side and fetal: maternal surface is rough, and from amniotic fetal coated with a special layer.

Violation of the aging steps

can determine whether the correct flow processes of growth and development of the placenta on the basis of ultrasound.

The whole body growing process can be divided into stages:

• Zero Stage, which starts from the moment of conception and continues until formation for 30 weeks. Baby seat has a homogeneous structure without inclusions. There active phase placental function.
• First step aging (the period 30 to 34 weeks) is characterized by the occurrence of fine irregularities and inclusions in the structure of the placenta. The functional activity of the body does not change.
• In the second step (Period from 34 to 37 weeks) Development observed gradual thinning and change of the relief of the placenta, there is a gradual fading of its functions.
• The third stage ends before the onset of labor. In this heterogeneous body structure and indicates the end of gestation and the approaching birth.

When diagnosing second step placenta ripening for up to 32 weeks, and a third step for up to 36 weeks premature aging process begins. This requires a systematic deviation of the regular observation and treatment.

What is placental abruption?

Each trimester of pregnancy is characterized by a particular process of development of the placenta, which meets the standards of its growth. If you violate the processes of growth observed failure of fetal development processes going on defective gas exchange, stops the supply of nutrients, production of hormones.

For various reasons, at any stage of pregnancy placenta from the uterine wall may occur before birth.

Placental abruption in early pregnancy from the mother membrane provokes blood accumulations in the void of the uterine wall. This can lead to oxygen starvation or lethal for the fetus. In partial placental abruption greatly increased risk of miscarriage, and in full - the risk of spontaneous abortion.

The reasons for rejection in early pregnancy

Deviation and pathology of the placenta occur in 0.4-1.4% of cases during pregnancy.

Normal functioning may be impaired due to these reasons:

1. Disruption of the vascular system. Inadequate blood permeability may be due to the fragile structure of the structure of the uterus and placenta capillaries.
2. The development of acute inflammatory processes in the uterus.
3. Strong toxicosis, which was observed in the first trimester.
4. Maternal diabetes.
5. Doing the wrong lifestyle. Consumption of alcoholic beverages, cigarettes, drugs has a large impact on the structure of the placenta.
6. The sharp fall injuries, strokes.

   

7. Congenital abnormal uterine structure.
8. Disorders of the thyroid, endocrine disruption, tumors, chronic diseases.
9. Stressful situations that affect blood pressure and provoke the separation of child seats.

Placental abruption in early pregnancy can occur for various reasons, but most of the changes in the functioning of the placenta caused by various factors.

Factors causing detachment in the later stages

The intensity of the symptoms will depend on the degree of rejection of child seats.

The appearance of pathological processes in the final stages of pregnancy may be triggered by the following factors:

• Previous generations that led to the stretching of the uterus wall and broke its dense structure.
• Excessive weight gain, which reaches the critical exponents.
• Stress.
• Childbearing beyond the allotted timeframe.
• Preeclampsia in late pregnancy.
  
• The use of drugs, provoking the appearance of allergic reactions.
• Autoimmune disease in which the cells of the body can be perceived as foreign.

Bleeding, pain, increased uterine tone should alert a woman and are obligatory indications for treatment to the doctor. After examination of the patient and the ultrasound examination can confirm the detachment of the placenta from the uterine wall.

The symptoms of placental abruption

Symptoms, which accompanies the internal process of rejection of the placenta at different stages of pregnancy may be different, including the intensity of sensations.

For example:

• In the first trimester observed most cases of retinal detachment. With timely diagnosis, in most cases it is possible to establish the functioning of the placenta. During this period, the woman has discomfort in the abdomen, there are varying degrees of bleeding.
• In the second trimester main symptom placenta rejection is beginning increase uterine tone, which is accompanied by voltage and painful pulling sensations.
  
• In the third trimester placenta is very dangerous, because the supply of placental growth possibilities have been exhausted. Symptomatology with the most vivid: pain, vaginal bleeding, pulling sensation, an ultrasound of the fetus noticeable deterioration of functioning: he is inactive, visibly suffering.
• Detachment of the placenta during childbirth often leads to their rapid stimulation or emergency delivery methods.

the blood compartment may be of external nature (the appearance of discharge) or internal, associated with the accumulation of blood in the void.

How to diagnose the pathology?

Placental abruption in early pregnancy has a pronounced symptoms. The presence of at least one of the symptoms - bleeding, cramping, pain, increased weakness - a direct cause for treatment to the doctor, which will help to diagnose the pathology.

To display the fullness of the diagnosis the doctor will conduct a comprehensive survey:

• Examination of the pregnant woman.
• Ultrasonography.
• Blood tests.

On palpation increasing uterine tone will be observed: it will be hard, may have asymmetric changes.

Most often for the patient such inspection will be accompanied by painful sensations.

With a weak main symptom is a method of diagnosing ultrasound, by means of which area is determined by the separated parts of the placenta, and the presence of internal blood accumulations.

therapies

The choice of treatment will depend entirely on the gestational age and the degree of placental abruption. Activities should not bring harm to the child's health, but they should be carried out without delay.

The decision on the method of treatment is accepted the doctor after the examination:

• Bed rest is recommended for women with mild placental abruption. At the same time improve the condition and remove the tone of the uterus help tocolytic therapy to relax the uterus, welcome antispasmodic, hemostatic therapy, and receive iron-containing preparations.
• When mature birth canal in late pregnancy often perform an autopsy of membranes by artificial means. The generic process is stimulated with drugs or carried caesarean section.

Placental abruption in early and late pregnancy requires regular inspection of the patient for fetal monitoring and the expectant mother. With the progression of complications physician may decided to hold an emergency delivery. When diagnosing a small detachment and the immaturity of the fetal pregnancy should maintain maximum possible period of time.

At home,

At occurrence of any pain in the abdomen or the beginning of the bleeding can not be carried out remedial measures themselves. The uncontrolled use of medicines can only make the problem worse and accelerate the irreversible death of the fetus.

The home should only follow the doctor's recommendations:

• Provide bed rest.
• Avoid heavy lifting.
• Fully fed.
• Saturate the body with vitamins.
• Implement reception designated medications.

The use of infusions of herbs without consulting a doctor is strictly contraindicated. In order to establish the full clinical picture must refrain from taking medications before visiting the doctor and inspection.

Medications

Development of pregnancy can not save in most cases, strict compliance with medical recommendations.

To improve the doctor will prescribe the administration of drugs depending on the condition of the pregnant woman:

1. Antispasmodics - "No-spa", "papaverine" magnesium sulfate.
   
2. Drugs to stop bleeding - "Vikasol", "Detsinon".
3. Iron supplements - "Sorbifer-durules", "Tardiferon".
4. Drugs to relax the uterus - "Magne-B6."

The use of drugs should be carried out after the appointment of a physician. Self-treatment, particularly at elevated threat of miscarriage, may lead to serious consequences.

Effects

Placental abruption in early pregnancy, and in the last trimester, threatens the emergence of complications of various kinds.

Maternally possible consequences of placental abruption can be:

• With a high degree of blood loss development of hemorrhagic shock, and even death.
• Failure of the work of some bodies.
• Loss of uterine contractions.
• Incoagulability blood.

Fetal possible consequences of not less dangerous:

• Prematurity.
• Hypoxia.
  
• Intrauterine death.
• Stillbirth.
• The lack of nutrients and vitamins needed for full development.

Careful monitoring of pregnancy of the woman and the physician increases the risk of a successful outcome of pregnancy.

Forecasts when passing child seats

Reliably predict the behavior of the woman's body during pregnancy can not no doctor, but to continue the pregnancy while respecting the doctor's recommendations with a high degree of probability succeed. Tactics of conducting pregnancy will depend on the performance of the current term and detachment, fetal status, such as bleeding.

Compared to late gestation fetal placenta rejection early pregnancy refers to the less dangerous. Treatment in the hospital maintains a full-fledged development of the fetus and to constantly monitor possible changes in his condition.

The main thrust of the treatment - the extension of pregnancy as long as possible before fully ripe fruit, and offensive readiness of the birth canal to the birth of the child. If you have any of the characteristic symptoms of a pregnant woman should not panic and inform the doctor about the state change.

Is it possible to avoid detachment of the placenta in the next pregnancy?

The risk of placental abruption retransmission is low and reaches the limits of 5-20% in percentage during subsequent pregnancies. Modern methods of medical treatment are not able to eliminate the occurrence of abnormal placenta, and can only help normalize the condition.

If the first pregnancy in women there are any complications, it is necessary to adhere to the general guidelines:

• Timely held ultrasound diagnostics.
  
• Follow the doctor's recommendations.
• To provide the right balance of wakefulness and rest.
• Eliminate heavy lifting and abdominal trauma.
• Adhere to the rules of healthy eating.
• Do not ignore the signs of chronic diseases.
• To monitor blood pressure.

Should notify a doctor who monitors the pregnancy of a previous pathology.

prevention

The most significant preventive measures for normal pregnancy and exclusion of placenta abnormalities include:

• Careful timely diagnosis of uterus cavity at all stages of pregnancy.
• Current therapy of inflammatory processes in order to reduce the risk of developing the chronic form.
• Avoiding injuries in the abdomen.
• Pressure control and regulation if necessary.
• Accounting for the state of blood vessels to the possibility of timely treatment when it detects violations.
• Judicious use of drugs to avoid the appearance of allergic reactions.

Placental abruption in early and late pregnancy is always increases the risk of serious consequences. If you ignore this problem may appear a risk of miscarriage or premature birth need. To the doctor should contact if any, even minor, symptoms to provide timely medical care of the future mother.

Registration of the article: Lozinski Oleg

Video of placental abruption

Premature detachment of normally situated placenta: