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Placental infarction occurs in about 1/3 of women suffering from arterial hypertension during pregnancy. Placental infarction in early pregnancy may cause miscarriage, and later in pregnancy may limit the development of the fetus, and even cause its death. What is a placental infarction? What are its causes and symptoms?
Placental infarctionis the death of a part of the placenta, specifically parts of the placental villi responsible for maternal-fetal replacement. Placental infarction occurs when the mother's blood flow to the placenta is severely restricted or interrupted.
According to research, placental infarction is closely related to intrauterine growth retardation, and thus - with a low birth weight of a child and a smaller circumference of a newborn's head than in he althy children. In addition, placental infarction in early pregnancy can causemiscarriage , and later in its development it can cause premature birth and even intrauterinefetal death .
Placental infarction - causes
Small placental infarctionsoccur quite frequently, even in he althy women, and are not dangerous to the development of the fetus and pregnant women. Threatening the he alth and life of the unborn child and mother isextensive placental infarction(involving more than 10% of the placenta). Usually, the cause of the restriction of the mother's blood flow to the placenta is uteroplacental thrombosis. This type of pathology of the vascular system is most often encountered in pregnant women with primary or pregnancy-induced hypertension (about 1/3 of cases), as well as in those in the pre-eclampsia and eclampsia with acute atherosclerosis of the uteroplacental vessels and a tendency to to thrombosis. In some cases, the reduction in the number of active villi of the placenta is caused by the increased perivillary accumulation of fibrin (fibrinous necrosis).
Placental infarction - symptoms
Hypertension (over 140 mmHg for systolic blood pressure and / or over 90 mmHg for diastolic blood pressure), lack of weight gain or abdominal circumference due to reduced fetal growth, and oligohydramnios, a condition in which the amount of amniotic fluid is not normal, symptoms may indicate a heart attackbearings.
A pregnant woman may also have symptoms of premature detachment of the placenta, such as sharp and violent pain in the lower abdomen, intense vaginal bleeding and shock caused by internal hemorrhage. It is worth knowing that the detachment of the placenta increases the risk of a heart attack even several times.
Preeclampsia may occur with a placental infarction, causing headaches, vomiting, vision problems, photosensitivity, fatigue, urinary retention, pain in the upper right abdomen and shortness of breath.
If a fetus has died as a result of a placental infarction, which, unfortunately, usually happens when the infarction occurs in the third trimester, the pregnant woman may feel a sudden change in the nature of her baby's movements, and then stop, which most often means that the baby's movements have stopped. to respiratory and circulatory failure and, consequently, to the death of the child in the womb.
Placental infarction - diagnosis
Placental infarction is difficult to diagnose during ultrasound examination, because it is usually visible as a hypoechoic focus (it is a darker place than other tissues due to the fact that it absorbs more ultrasound), which may also indicate, for example, a cancerous tumor . An ultrasound scan, however, can detect abnormalities such as a limited baby's height and oligohydramnios.
If a placental infarction is suspected, it is best to test the degradation products of fibrinogen / fibrin. Fibrins are fragments of fibrin formed as a result of the intensification of the process of fibrinolysis - the breakdown of intravascular clots.
Is it possible to give birth to a he althy baby after a placental infarction?
Research shows that most women can have a live baby after a placental infarction. Unfortunately, placental insufficiency in more than 50 percent. cases affect the low birth weight of the child, a smaller head circumference than in he althy children, and other parameters of intrauterine growth, which translates into a low Apgar score.
Placental infarction - treatment
Fetal heart function and uterine contractions should be monitored continuously. The basic procedure in such cases is termination of pregnancy by caesarean section, provided that the fetus is capable of ectopic life.