Premature separation of the placenta is one of the emergencies in obstetrics that should be associated with major hemorrhage and an uncertain prognosis for the he alth and life of the mother and child. In most cases, the problem concerns the correctly seated placenta, although experts are trying to find a relationship between the marginally or centrally advanced placenta and the pathology in question.

The termpremature detachment of the placentadescribes a situation in which there is a complete or partial detachment of placenta fragments from the uterine wall, before the baby is born, i.e. also during childbirth, but after the completion of 24 weeks pregnant. It should be noted that there are certain stages of childbirth, and a certain sequence is followed. In the first stage, the baby is born, and only then the placenta. It does not matter whether it is a delivery by means of natural means or a surgical delivery by caesarean section. Therefore, premature detachment of the placenta - before the birth of a child - is a pathology and is associated with a high mortality rate, especially in newborns.

By far the biggest problem with a premature detachment of the placenta is the concomitant heavy bleeding. The source is between the uterine wall and the placenta on the maternal side. A hematoma occurs at this point. The enlarging hematoma naturally increases the space between the uterus and the placenta, which significantly impairs the exchange of oxygen and nutrients. It is very important to be aware of the two forms of bleeding. In the overt form, the blood flows out, while in the hidden form, more difficult to recognize, the blood does not come out, but gradually seeps towards the uterine muscle, resulting in a uterine stroke.

Premature detachment of placenta: causes

The factors that relatively increase the probability of premature detachment of the placenta include:

  • hypertension, which causes damage to the blood vessels of the placenta, and then hematoma, which is a factor that triggers the process of detachment of the placenta
  • a multiple pregnancy predisposes to a placenta larger than in a single pregnancy, which increases the risk of incorrect implantation
  • nicotinism in pregnancy, which can cause changes in the vascular wallblood vessels, impaired perfusion and a direct impact on the formation of retrograde changes in the placenta
  • burdened obstetric interview, especially when the discussed pathology was diagnosed in a previous pregnancy, which imposes an obligation on the obstetrician to exercise particular caution towards such a patient throughout pregnancy
  • multiparous (>3 births in interview)

Symptoms of premature detachment of the placenta

Immediate intervention results from quick recognition. Suspicion of the discussed pathology can be made on the basis of symptoms:

  • pain in the lower abdomen of constant intensity, but increasing intensity
  • disturbed perceived movements of the fetus - the child is too active or not very mobile
  • tightening of the uterine muscle
  • heavy bleeding which is the first sign that should always persuade the patient to seek help from a specialist. The amount of blood lost can vary with the type of bleeding. It should be emphasized that excessive blood loss is closely associated with a high risk of shock development - most often it is a hypovolemic shock. The most characteristic symptoms are: pale, damp and cold skin of the patient.

Complications of premature detachment of the placenta

By far the biggest complications are associated with profuse bleeding and significant blood loss, which can lead to the death of the mother and child. In addition, the mother may develop ischemic uterine necrosis as a result of an enlarged hematoma that presses on the pelvic organs, resulting in hypoxia. One must always remember about a rare, but periodically occurring complication, which is Sheehan's syndrome, which manifests itself in hypopituitarism. The course of this syndrome is electrifying. Gland ischemia and necrotic changes occur quickly, which impairs the proper functioning of the pituitary gland. Always excessive blood loss carries an increased risk of intravascular coagulation syndrome, which unfortunately is fatal in most cases.

Treatment of premature detachment of the placenta

Final diagnosis is not made until after surgery. However, before that, ailments may appear suggesting this state of affairs. These are symptoms of a life-threatening condition for the mother and child, profuse bleeding from the genital tract, which is an indication for an immediate caesarean section. Waiting procedure is dedicated only in cases of unborn pregnancies in order to reduce the complications of extreme prematurity. In such situations, there is a bed regime, intensive supervision of the fetus, and more preciselyassessment of his well-being. Take care of lung development by administering drugs stimulating the maturation of the respiratory system - a course of prenatal steroid therapy.

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Pregnancy