A placenta is a very important organ that initially develops from the same cells as the baby himself. Until 11-16 weeks, it is called the chorion, the villous shell of the embryo: its villi penetrate the thickness of the uterine wall, oxygen and food are supplied to the baby through it, and its waste products and carbon dioxide are removed. After this period, a full-fledged placenta is formed, which also has many villi, but, in addition to nutrition, also produces hormones (in particular, progesterone) that help maintain pregnancy (the yellow body in the ovary performs this function before the formation of the placenta ).
The placenta does not have a contractile function, but attaches to the uterus - a strong and large muscle, which even before the onset of labor periodically briefly “trains”, which is expressed in the reduction of its individual sections for a short period of time. Usually, the placenta adjusts to these movements, and nothing happens to it, but sometimes a situation arises when its larger or smaller portion exfoliates from the uterine wall. Then the fetus suffers, as its nutrition is disturbed. In addition, this condition can lead to the death of the mother and fetus, so the symptoms of placental abruption should be brought to the attention of both pregnant women and their families.
What is placental abruption?
Normally, the placenta should attach closer to the top, that is, the bottom of the uterus, usually along its posterior wall, but sometimes it is located closer to the exit - the cervical canal. This is called placenta previa. It can be full or central when the child's place is on both sides of the exit from the uterus, blocking the exit from it. It may also be that the placenta is just a little lower than necessary. Such placentation is predisposing to detachment.
Thus, a normally located or pre-existing placenta can exfoliate. The symptoms of placental abruption depend on how it is located.
Also, manifestations will depend on such factors:
- the detachment continues or she was able to stop;
- where did it separate from the uterine wall - in the center or on the edge;
- in what periods of pregnancy or even childbirth such a condition developed: placental abruption in the early stages, if a very small portion of it has departed from the uterine wall, has a mild course and a favorable prognosis, since subsequently the child's place will still grow and develop, and it is likely that the defect closes and “outgrows”.
What symptoms can be observed with placental abruption?The main are three signs:
1) Bleeding from the vagina of varying intensity.
2) Pain in the abdomen, its lower sections.
3) Signs of fetal suffering: a change in heart rate, an increase or decrease in its motor activity.
Symptoms of placental abruption, depending on the clinical situation, are as follows:
I. If there is an abruption of the placental placenta from the edge, there is mainly only bleeding, pain almost does not occur. If such a small area exfoliates, the fetus does not suffer.
II. If the placenta, wherever it is located, exfoliates in the central area, and the bleeding stops (that is, non-progressive detachment), then there may be no symptoms. A woman will find out about this case on an ultrasound scan or, after the fact, a little brown blood is released after the fact.
III. If the detachment of a normally located placenta in the marginal segment exfoliates, two of three symptoms may be present: bleeding and pain. If the bleeding does not stop, then the fetus begins to suffer, contractions and premature birth can begin (or a miscarriage, if this is a placental abruption in the first trimester).
IV. When the detachment of the central part of the placenta occurred, blood accumulates behind the placenta. This is called a retroplacental hematoma. It by itself, even if the bleeding has stopped, is able to exfoliate the placenta further. As a result, a significant area, and even a whole placenta, can exfoliate. Blood with such a partial detachment does not always stand out. Then the symptoms of placental abruption are: weakness, pallor, palpitations of a woman, she feels pain in the abdomen, tension of the uterus, the baby first moves more often, then it can calm down altogether. With further impregnation of the walls of the uterus with blood from the hematoma, the pain intensifies, the uterus does not relax. If the blood finds a way out, it pours out of the vagina.
V. The placenta can exfoliate during childbirth. Then bleeding also occurs, clots may be released. The uterus does not relax well beyond contractions; if the fetus suffers, then its dark cal - meconium is secreted. These signs should be noted by obstetrician-gynecologists
What if you think your placenta has exfoliated?
With any blood discharge during pregnancy, even if it is a brown “daub”, you must take a horizontal position and inform your gynecologist who is watching you. If scarlet blood is secreted, you must lie down immediately, do not even get in the toilet, be sure to call an ambulance and ensure maximum peace. If the child (by ultrasound) developed normally, you do not have severe gestosis or chronic pathology, there is a high probability that you will stop bleeding with the strictest bed rest, and then the help will come in time. Stopping bleeding in case of detachment of the placenta does not mean that you can get up, you have to go to the toilet even on the vessel for several days.