Pregnancy and childbirth are 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, everyone, including a woman who has given birth repeatedly, still worries how her baby will be born. With all the skill of obstetrician-gynecologists, unexpected complications can arise in the most equipped clinic during childbirth. For example, delayed afterbirth. What is this complication, and what are the causes of its occurrence?
What is the placenta?
During pregnancy, a placenta is formed from the embryo tissue in the woman’s uterus, or, as this entity is also called, a "baby place". The process of its formation occurs in the first three months of pregnancy. The diagram above shows that on one side the child's place is attached to the wall of the uterus, then it goes into the umbilical cord connecting the fetus with the mother. The placenta grows with the fetus, and only at 36 weeks of pregnancy its growth stops. She becomes the so-called "mature" placenta.
The main functions of the placenta
So, we will consider what the temporarily forming organ does, which is inherent in absolutely all mammals, which include humans:
- transportation of beneficial substances from the mother's body to the fetus;
- elimination of the vital products of the fetus;
- gas exchange (oxygen flows from the mother’s body to the fetus, carbon dioxide from the fetus to the mother);
- synthesis of many hormones;
- a barrier to harmful substances and pathogens.
What is a afterbirth?
The aftermath is a placenta with fetal membranes and an umbilical cord. So the complete identification of two concepts: the "placenta" and "placenta" is not entirely true. Such a merger of concepts is explained simply: the successful release of the afterbirth directly depends on how well the child's place separates from the uterine wall. The last comes after the birth of the child (in fact, this is clear from the name itself). This happens in the third period of labor.
The afterbirth: the process of expulsion from the uterus
The generic activity of a woman occurs in three stages.
The first stage: smoothing and opening the cervical canal of the uterus. That is, the uterus should open so that the fetus is expelled from its cavity. This is about 10 centimeters, or, as midwives used to say , with five transverse fingers.
The second stage is the birth of a child.
And then comes the third, final stage: the detachment of the fruit membranes and the baby place from the uterine walls and the birth of the afterbirth. This happens as follows: in the period 30 minutes after the birth of the child, the uterus begins to contract again. A placenta that 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 afterbirth is expelled. This is normal. But a complication is possible when the placenta does not exfoliate completely or does not separate at all.
Why is the placenta not separated?
There may be several reasons for this:
- decrease in uterine contractions;
- tight attachment of the child's place to the wall;
- an increment to the wall, up to the penetration of placental tissues into the deep layers of the uterus (the most formidable pathology);
- irregular structure (too thin or having two lobes of the placenta);
- the location of the placenta in the lower parts of the uterus;
- location in the area of the myoma node.
What do they do if the last is not left?
If the doctor has determined the development of such a complication as the non-discharge of the placenta, a number of measures are taken to stimulate uterine contractions. The first thing an obstetrician-gynecologist advises you to do is massage your nipples. Typically, this simple procedure helps to expel the aftermath. It did not help? Then, in order to stimulate contractions, catheterize the bladder and administer drugs. In the absence of the results of the measures taken, after 30 minutes the last is manually separated. This event is carried out under general anesthesia. If you suspect that the placenta has grown into the thickness of the uterine wall, the woman in labor is prepared for surgical 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.
- In the postpartum period, endometritis may develop.
- Blood poisoning (sepsis).
Causes of delayed afterbirth
Why doesn’t the last come out? This is due to a number of health problems that a woman in labor acquired before pregnancy:
- dystrophic changes in the uterus, scars after surgical interventions;
- inflammation of the mucous layer of the uterus;
- frequent curettage of the uterine mucosa.
Prevention
Violations of the birth of the placenta can be avoided by adhering to the following rules:
- You should prepare for pregnancy, plan it, taking into account the state of health, domestic factors and the psycho-emotional state.
- Prevent infectious and inflammatory diseases of the genitourinary system and pelvic organs: exclude accidental sexual intercourse, use condoms during sexual intercourse, observe the rules of intimate hygiene.
- Timely cure the disease.
- During pregnancy, timely find an experienced and responsible doctor whom you can trust; register (up to 12 weeks of pregnancy).
- Monthly attend a antenatal 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, salty foods.
- Compliance with the daily routine: it is very important to sleep a sufficient amount of time.
- Compliance with the recommendations and instructions of your gynecologist.
- Refusal of bad habits and the use of alcohol.
- Adequate physical activity, performing physical exercises for pregnant women.
Optimistic
Forewarned is forearmed. Of course, a delay in the afterbirth is not a pleasant complication. But in the case of careful attention to your health and the health of your future little miracle, the fulfillment of all the recommendations of the doctor who observes your pregnancy, the birth will probably be successful. Indeed, according to statistics, such an unpleasant complication as an increase in the placenta to the uterus, which can lead to surgical intervention, is very rare: 1 case per 24 thousand women in labor.
Health to you and your children.