Placental abruption at 34 weeks symptoms. Serious complications during pregnancy: placental abruption. What threatens placental abruption to the fetus

Despite the fact that the word "placenta" is on everyone's lips, most often, having become pregnant, future mom have a hard time imagining what it is. Whereas in fact, knowing the features of the development of the placenta, you can avoid many pitfalls during pregnancy.

Despite the fact that the placenta, nourishing the child with maternal antibodies, is able to protect the fetus from most viruses and infections, it does not have the ability to limit the entry of poisons such as alcohol, drugs and nicotine into the baby's body.

The placenta is a unique organ that appears in the body of a woman only during pregnancy, and circulates nutrients from mother to child, providing it with everything necessary for growth and proper development.

The placenta is multifunctional. It provides the fetus with oxygen and minerals. At the same time, it removes decay products (urea) from the baby's body. Another important feature " children's place"is the synthesis of hormones. Depending on what the body needs at a particular moment, it is able to secrete lactogen (a hormone responsible for the maturation of the mammary glands and preparing the body for feeding), prolactin (responsible for lactation itself), relaxin (relaxing and analgesic hormone), estrogen, and others.

And, of course, the placenta plays an important role as a regulator of immunity, saturating the fetus with maternal antibodies and preventing the conflict between the immune cells of the mother and baby.

The placenta is formed simultaneously with the development of the fetus. At an early stage, it is called the chorion (or villous membrane) and looks like thin outgrowths with which the fetus is attached to the wall of the uterus. Every day, the chorion grows in breadth, covering an increasing area of the uterine surface. By the second month, this organ turns into a formed children's place.

The placenta is constantly growing and changing with the baby until the very birth. There are placental growth rates for each stage of pregnancy. This rate is called the degree of maturation. There are four degrees of maturation of the placenta: zero (up to thirty weeks), first (from the twenty-eighth to the thirty-fourth week), second (from the thirty-fourth to the thirty-eighth) and third (from the thirty-eighth week until the baby is born). Immediately before childbirth, the placenta no longer grows, but enters the aging phase.

Ideally, all stages of maturation should correspond to the deadlines, because the life of the baby depends on it. But each pregnancy is different, and sometimes during the course of pregnancy, various deviations from the norm can occur. That is why it is very important to control the development of the placenta.

While the 34th week of pregnancy is underway, the placenta usually reaches its peak of development. It is at this time that it is recommended to do an ultrasound examination (ultrasound). The placenta at 34 weeks should have a wavy surface with many echopositive inclusions. During the ultrasound, it is possible to identify all anomalies in the development of a child's place, if, of course, there are any.

In the event that premature maturation of the placenta occurs, 34 weeks is the period when measures can still be taken. In this case, complex treatment is usually prescribed, consisting of drugs aimed at maintaining the vital functions of the child's place and preventing hypoxia (lack of oxygen) in the child.

With regard to late maturation, it is much less common and, as a rule, is the result of maternal illness or the use of alcohol, nicotine or drugs during pregnancy.

Another dangerous point is the thickness of the placenta at 34 weeks. Normally, it should be from thirty-three to forty-three millimeters. Thickening of the placenta may indicate a conflict between the immune cells of the mother and baby, as well as the presence of a future mother diabetes.

With the premature maturation of a child's place, such a problem as low placentation can also be identified: 34 weeks of the term in this case is a cause for concern, since heavy bleeding is possible. In this case, the woman is subject to immediate hospitalization. Low placentation threatens abortion, anemia and hypoxia.

If there is no spotting or they are not plentiful, the expectant mother can stay at home, subject to regular visits to the doctor. In this case, a calm lifestyle is shown: you need to lie more, raising your legs up and try not to be nervous.

In some cases, the placenta rises on its own by the time the baby is born. But it also happens that it remains down until the thirty-seventh week. It's already alarm signal. Childbirth in this position of the placenta is quite possible, but, again, subject to the mandatory hospitalization of the pregnant woman to identify the safe way childbirth. In the event that there is no threat to the life of the child and mother, the baby is removed in the usual way- through the birth canal. In a more difficult situation, C-section.

Since the thirties of the twentieth century, the placenta has often been used in the development of pharmacological drugs. The extract of the "children's place" has an antibacterial and antiviral effect. In addition, stem cells are obtained from the placenta.

The placenta is the most important organ at the time of pregnancy, because the life of the baby depends on its condition. Therefore, it is imperative to monitor the growth of the placenta in parallel with the development of the child, so that, if necessary, take all necessary measures in time.

The placenta plays an important role in the development of the fetus. Through it, the baby eats and breathes, so deviations from the norm are dangerous at any stage. If the expectant mother suddenly found placental abruption in the early stages of pregnancy, then prompt observation and intervention of specialists is required. The cost of delay may be the life of the baby.

After the conception of a child, a fertilized egg begins to form. It is fixed on the wall of the uterus and continuously grows. At this stage, the chorion appears. These are villi that tear the surface of the fetus. Small vessels pass through the outgrowths of the chorion, with the help of which penetration into the inner membrane of the uterus and fixation in it occurs. The chorionic villi are immersed in blood from the outside. Such a system allows the fetus to receive oxygen, nutrients, and in return to give carbon dioxide and waste products.

The placenta for a child is the lungs, kidneys, digestive organs, skin. The consequence of detachment of the chorion in the early stages of pregnancy may be a miscarriage, therefore, it is impossible to do without surgical intervention.

Life cycle of a children's place

The placenta forms during the first 12 weeks of pregnancy. What follows is continuous growth. By 34 weeks, the baby's place reaches its maximum size and begins to age. This is a natural process in which 4 stages can be distinguished:

lasts up to 27-30 weeks;
active growth from 27-34 weeks;
maturity period, which covers 34-39 weeks;
aging from 37 weeks to childbirth.

Violation of the stages of aging

Sometimes the aging of the placenta occurs prematurely. It can be caused by the characteristics of the woman's body or a number of pathologies:

the second half of the term;
toxic substances and medicines;
uterine injury;
multiple pregnancy;
, drugs;
chronic diseases;
malnutrition or diet;
and consequences of previous difficult births;
infections in the uterine cavity.

Early maturation of the placenta during pregnancy leads to oxygen starvation of the fetus and a lack of nutrients. He can lose weight, develop abnormally and be born unhealthy. To avoid serious consequences, you need to be regularly observed by a doctor, undergo a course of treatment.

What is a detachment?

Detachment of a child's place is its separation from the inner surface of the uterus. It may be partial or complete. The resulting void is filled with blood, which further repels the chorion. The process of separation should occur in childbirth, but it can also be premature. Chorionic detachment in early pregnancy is dangerous for the baby, because it can leave him without oxygen and useful nutrients.

Degrees of detachment of the child's place:

The discharge area is less than 1/3, which does not harm the child, can be compensated for by his growth. Pregnancy is saved and continued.
Detachment by half can lead the fetus to death from oxygen starvation.
Full. Almost always carries the death of the baby.

The latter ends, and the first two are attributed to the threat of spontaneous abortion.

Why is the chorion rejected?

According to statistics, 0.4-1.4% of pregnant women face the problem of premature rejection of a child's place. This can happen in the first or second birth period, but most often the latter poses the greatest danger. Among the causes of placental abruption in early pregnancy are:

woman's age;
the presence of harmful addictions;
a large number of births;
malnutrition;
infection or inflammation in the uterus;
chronic diseases;
abdominal trauma;
pathology of the uterus or placenta;
preeclampsia;
a long period of infertility before conception.

Symptoms of premature rejection

The main signs of placental abruption in early pregnancy:

- can be external or internal. If separation occurs at the edges, then discharge appears from the vagina. Internal bleeding is more difficult to detect. It occurs with the central detachment of the child's place, when the edges remain attached, and fluid accumulates in the resulting space. An urgent surgical intervention is needed (sometimes with complete removal of the uterus). It will be about saving the mother. The fetus usually does not survive.
Mild aching pain, provoked by increased. It may radiate to the groin area or thigh and be a clear sign of internal bleeding.
Violation in the cardiac activity of the fetus. The condition will be affected by maternal blood loss and the amount of detachment. Insufficiency will appear already when 1/4 of the area of \u200b\u200bthe child's place is discharged. Severe oxygen starvation occurs at 1/3 of the part, after which death may occur. If half of the placenta has passed, then the pregnancy will be impossible to maintain.
Nausea, vomiting, dizziness, anxiety.

Identification and prompt elimination of the problem with placental abruption

A small detachment of the placenta in early pregnancy is not always accompanied by visible symptoms. It can be detected only with the help of timely diagnostics. It is important to regularly attend scheduled medical consultations.

Diagnosing the condition of the placenta

It is possible to diagnose placental rejection in early pregnancy during the procedure. This procedure allows you to identify retroplacental hematoma, accompanied by destroyed or oppressed tissues. In the early stages of a neoplasm, it may not yet be. Diagnosis is made by excluding diseases with similar symptoms. If the placenta is rejected, an ultrasound can detect blood clots behind it. The vagina can be carefully examined to exclude their damage, the presence of infections, tumors and other abnormalities.

Predictions for the departure of a child's place

This pathology is not uncommon. Prompt and qualified treatment can prevent its consequences. Timely detection of the problem and taking measures can stop the process and give a positive prognosis for the course of pregnancy in the future.

A small detachment of the placenta requires inpatient observation and treatment. The assistance provided will allow the child to develop normally. It is unacceptable to ignore any alarming symptoms during pregnancy. Departure of a child's place is a serious pathology. It can lead to irreparable consequences.

The question of the treatment of detachment of a child's place - not an easy task. Often you have to choose operative delivery. Additionally, blood clotting is monitored. It is important to deal with the shock state of a woman and replenish blood loss.

How is placental abruption treated?

The appointment of treatment for placental abruption in early pregnancy and beyond depends on various factors:

the general condition of the woman and the child;
trimester of pregnancy or childbirth;
volume of blood loss.

Operative delivery can be replaced by treatment if:

gestational age less than 36 weeks;
a small area of detachment and there is no progression of the process;
cessation of discharges or small volumes;
lack of signs of lack of oxygen for the child;
well-being of the pregnant woman and hospital stay.

Doctors prescribe mandatory bed rest for the expectant mother, regular ultrasound, as well as dopleometry and cardiotocography. Her condition must be strictly controlled. Laboratory tests of blood for clotting are carried out.

For treatment, antispasmodic drugs (,), hemostatic (Vikasol), anti-anemic (with a high concentration of iron) and aimed at relaxing the uterus can be used. In the presence of other diseases or complications, concomitant therapy is additionally prescribed.

Operative delivery may be prescribed if spotting begins to appear during observation in the hospital. This is a sign of the progress of placental abruption. On the later dates The most common is an emergency caesarean section. But natural childbirth can also be stimulated. The decision is made based on the condition of the mother and baby.

Surgical intervention takes place under the continuous supervision of doctors over the state of the child's cardiac system. Natural childbirth will require a mandatory examination of the uterine cavity manually after they are completed. At caesarean section, her condition is also assessed. If the muscle layer is saturated with blood, a complete removal of the uterus is necessary in order to avoid further bleeding.

Preventive measures for exfoliation of the placenta

There are no specific measures to prevent the pathology of a child's place today. This is due to the lack of confirmed causes of placental abruption in early pregnancy. Only a number of factors have been identified that may predispose a woman to the appearance of such disorders.

Prevention usually consists of:

regular visits to the doctor and the passage of the required examinations;
timely delivery of all tests;
avoidance of stressful situations;
good and;
complete rest;
healthy lifestyle;
prevention of possible injuries;
a sufficient number of walks in the air;
control .

Taking any medication should be strictly prescribed by a doctor and only when absolutely necessary. Treatment of chronic diseases can be regarded as the prevention of the occurrence of complications and exfoliation of the child's place.

Subsequent pregnancies: will there be a recurrence?

For women who have had placental abruption in early pregnancy, there is a high probability of a recurrence of the situation in the future. About 25% of cases end the same way. Medicine cannot yet completely exclude the possibility of exfoliation of the child's place during subsequent pregnancies. However, you can try to prevent the repetition of violations on your own. To do this, it is worth adhering to the above preventive measures in order to minimize all risk factors.

Departure of a child's place is a serious and dangerous pathology for a pregnant woman and her child. Many women face it. It is important to seek help immediately if you experience any worrisome symptoms. If there is no threat to life and health, then the pregnancy will continue, but under closer control, most likely in a hospital. The progression of the pathology in the later stages will require operative delivery. According to the state of the mother and baby, stimulation of natural childbirth or caesarean section can be chosen. If you do not pay due attention to the exfoliation of the child's place, the consequences will be severe and irreversible. In the early stages, everything will end in a miscarriage.

Take care of yourself and your child! Don't neglect to see a doctor!

Typically, the placenta is attached to the top of the uterus and remains there until the baby is born. During the last stage of labor, the placenta separates from the uterus, and with the help of labor pains, the placenta is pushed into the birth canal. This is called "the birth of the afterbirth."

Approximately 1 in 100 pregnant women (1%) It usually occurs during the third trimester of pregnancy, but can occur any time after the 20th week of pregnancy.

Placental abruption can be mild, moderate or severe. If the detachment is mild, that is, not the entire placenta has separated from the uterine wall, but only a small part of it, as a rule, does not pose a serious danger. But if the detachment is severe (the distance between the placenta and the uterus is large), then the child may have the following problems:

insufficient height and weight;
premature birth (before the full 37 weeks of pregnancy);
stillbirth (when a baby dies in the womb before birth but after 20 weeks of pregnancy).

Placental abruption is associated with about 1 in 10 premature birth(ten%). The birth of a child prematurely threatens him with health problems in the neonatal period (the first four weeks of life), the first week is especially dangerous. If a child was born severely premature, then he may subsequently be diagnosed with a disability, and he may even die.

Symptoms of placental abruption

The main symptom of placental abruption is bleeding from the vagina. Also, a woman may experience discomfort and soreness in the lower abdomen or back pain. Sometimes these symptoms can occur without vaginal bleeding, if the detached placenta has blocked the uterine os, and the blood simply cannot seep out. Therefore, if you suddenly feel pain in the abdomen, consult a doctor.

If the doctor suspects that the placenta has exfoliated in a woman, she will be hospitalized in a hospital or maternity hospital. Accurate diagnosis is carried out using medical examination and ultrasound.

Causes of placental abruption

It is impossible to name the exact reason due to which the detachment occurred. But it has been proven that women who are at high risk of placental abruption are:

smoke cigarettes during pregnancy;
use drugs, especially cocaine;
over 35 years old;
suffer from high blood (arterial) pressure;
have an infection in the uterus;
have problems with the uterus or umbilical cord;
have previously experienced detachment in previous pregnancies (if a woman had detachment in a previous pregnancy, then the likelihood that this will happen again is more than 10%);
pregnant with twins, triplets and a large number of children;
(excess amniotic fluid);
who had a ruptured membranes before the pregnancy reached the full 37 weeks;
have been injured in the abdomen, for example, during a car accident or as a result of physical violence.

Treatment of placental abruption

Treatment depends on how severe the detachment is and how long the pregnancy is. In mild cases, the doctor will simply monitor the condition of the woman and her child. But in more serious cases, a woman is prescribed delivery, regardless of the gestational age.

If the pregnancy is still very short, and the woman needs to give birth urgently, the doctor will prescribe her corticosteroids - medications, which help accelerate the development of the child's lungs and other organs.

1. Mild placental abruption - if women light detachment at 24 - 34 weeks of gestation, she needs careful observation in the hospital. If tests and examinations show that she and her baby are doing well, the doctor will prescribe treatment to keep her pregnant for as long as possible. Often a woman is advised to stay in the hospital until she gives birth. But if the detachment is not accompanied by bleeding, then the woman can be allowed to go home.

If a woman has a mild detachment at term, then the doctor may recommend induction of labor or a caesarean section, or wait for the natural onset of labor.

But a woman will definitely be assigned an emergency delivery, even with a slight detachment, if:

placental abruption worsens;
the woman is bleeding heavily;
there are problems with the condition of the fetus.

2. Moderate (moderate) or severe placental abruption In such cases, an emergency delivery is usually recommended, usually by caesarean section.

If a woman has lost a lot of blood due to a detachment, a blood transfusion may be needed. In very rare cases, if a woman has heavy bleeding that cannot be stopped, she may need a hysterectomy - the removal of the uterus by surgery. A hysterectomy can prevent fatal bleeding and other health problems for the woman in labor. Unfortunately, such a woman will never be able to get pregnant again.

In most cases, prevent placental abruption during pregnancy impossible. But you can reduce your risk by not smoking or taking drugs, taking medication for hypertension (high blood pressure) if you have it, and by always driving with your seatbelt on.

Premature detachment of the placenta during pregnancy is a very serious diagnosis, which, depending on the degree of complexity and without proper treatment, can lead to. If this problem is observed at the edges, then the blood will penetrate between the membranes of the uterus and the wall - this bleeding is called "external". Signs of "internal" bleeding have more pronounced symptoms: blood begins to saturate the uterine wall and, thus, exfoliates the muscle fibers, forming a hematoma, after which the uterus takes on a peculiar shape and consistency. This pathology can be diagnosed with ultrasound at an early stage.

Placenta and its detachment

The placenta is a special connective tissue, similar to a large cake, which directly connects the mother and her baby. It is with the help of the placenta that the baby receives all the nutrients and oxygen it needs. If the placenta does not function normally, then the life and development of the child in the womb is impossible.

Placental abruption is called its premature separation from the uterine wall, which disrupts the normal function of this organ up to complete cessation. Placental abruption can happen at different stages of pregnancy: in the first weeks or immediately before childbirth. Moreover, if placental abruption occurred before the 20th week of pregnancy, then the chance to bear and give birth to a normal healthy child is much higher than if this happens at a later date. The thing is that the placenta grows in the first half of pregnancy and there is a high probability that this organ can in some way compensate for part of the lost surface, in contact with the walls of the uterus.

According to statistics, premature detachment of the placenta is registered as one case in 120 pregnancies. Unfortunately, every sixth baby dies.

There are three degrees of placental abruption:

First: with this pathology, the child does not suffer at all. If placental abruption is less than 1/3, then there is every chance to continue the pregnancy.
Second: there is a risk for the baby to die from hypoxia. Detachment occurred halfway.
Third: the child almost always dies. Complete detachment.

Experts call a partial detachment a "threat of miscarriage", and a complete one - a miscarriage.

Symptoms:

Bleeding from the genital tract (vaginal or uterine). In 80% of pregnant women with placental abruption, spotting from the vagina is observed, but bleeding can also be internal. If internal bleeding was not diagnosed in a timely manner, then the main task of physicians is to save the life of the mother, since the fetus (mostly dead by that time) is removed along with the uterus. This situation arises due to the fact that the placenta exfoliates in the center, the blood gradually fills the free space and gradually impregnates the wall of the uterus, as a result of which it loses its contractile abilities. This process was first described by Kuveler, so the state is named after him. External bleeding is usually not as heavy as internal bleeding, and if it is not secondary, then its appearance can contribute to the thrombus of damaged vessels, thereby preventing further complications.
Pain in the abdomen and This symptom is observed in 70% of cases of premature detachment of the placenta. Most patients describe the pain as dull, aching and radiating to the thigh or perineum. Particularly severe pain occurs with internal bleeding.
Violation of the cardiac activity of the fetus. As mentioned earlier, the fetus receives oxygen through the placenta, therefore, with detachment of 25% of the area, hypoxia develops in the fetus, the area of detachment of 30% is already threatening, and 50% leads to its death.

These symptoms are classic and depending on the duration of pregnancy, they can manifest themselves in different ways.

So, in the early stages, this complication is accompanied by minor external bleeding and, with appropriate therapy, the pregnancy proceeds without complications in the future, and in the second trimester, increased uterine tone and the development of fetal hypoxia are added to the bleeding. Until the middle of the second trimester, they are monitored and, if necessary, treated, but if detachment occurs in the second half of pregnancy, then the question of premature delivery by caesarean section is raised. It is also worth noting that the clinical picture of placental abruption, in addition to the main symptoms, also has such manifestations as rapid breathing, anxiety, dizziness and faintness, as well as bouts of nausea and even vomiting.

Causes of premature placental abruption

Until now, experts still cannot name what are the causes of placental abruption. Previously, there was an opinion that a woman’s wrong lifestyle leads to this: for example, if she smokes, drinks or uses drugs, and also if her diet is not varied and the expectant mother does not receive any vitamins, minerals and trace elements. But there is no scientific evidence that this is actually the case. However, scientists have good reason to believe that problems with blood vessels lead to this defect, for example, late preeclampsia or arterial hypertension. Often, placental abruption is a consequence of a stroke, for example, when a woman receives an abdominal injury. Sometimes there is placental abruption with polyhydramnios and with multiple pregnancy- immediately before childbirth or in childbirth. Doctors say that in this case, the cause of detachment is a sharp decrease in intrauterine pressure. By the way, not only their pathology can lead to the transformation of blood vessels, but also various ailments, such as hypovitaminosis or nephritis.

First of all, a woman who feels nausea and dizziness, which are accompanied by abdominal pain, vomiting, rapid pulse and pale skin, should suspect a serious illness and immediately go to the hospital for help.

Treatment and prognosis

Treatment of this problem depends on the duration of pregnancy and the degree of pathology. With a short term, they try in every possible way to save the child, and the pregnancy is carried out very conservatively. With a full-term pregnancy, doctors can stimulate a woman, while if the detachment is small, then the pregnant woman can give birth herself. If the detachment is large, and it poses a threat to the life of the baby, then the woman must have a caesarean section. During childbirth, you need to open the bladder - this, most often, stops the exfoliation of the placenta, and also accelerates the emptying of the uterus - forceps are also used for this. In this case, the placenta must be removed manually, and the uterine cavity is carefully examined.
Often, immediately after childbirth, a woman may begin bleeding due to the fact that there is insufficient uterine tone and there is a violation of blood clotting. If a large hemorrhage occurs in the uterus, then after a caesarean section, doctors do an amputation. That is, if the bleeding fails to stop, the uterus continues to shrink, and blood transfusion and hemostatic therapy do not work, then doctors may even decide to remove the uterus.
As for re-pregnancy, after placental abruption, experts advise getting pregnant no earlier than a year later. Just during this time, the uterus is able to fully recover after the operation, and the woman's body will again be ready for the birth of a new life inside. But, do not forget that doctors say that a second pregnancy can occur with the same complication, so before and during it, you should listen to the advice of doctors and follow all their instructions.

Detachment of a normally located placenta is considered one of the most difficult conditions that occur during pregnancy. With this pathology, the danger threatens both the woman and her child. The most severe consequences occur with placental abruption in late pregnancy.

Causes of placental abruption

Without the placenta, the child simply could not exist in the womb for all nine months. It is the fetal place that guarantees the supply of oxygen, nutrients and vitamins to the baby. In the event that the placenta for some reason does not cope with its functions, they speak of its insufficiency. In more severe situations, the fetal place may even move away from the uterine wall and lead to the death of the fetus.

Under normal conditions, the placenta is born immediately after the birth of the child. It happens that the placenta exfoliates much earlier than the due date. In the second half of pregnancy, the following factors lead to the occurrence of this pathology:

severe gestosis;
kidney disease;
exacerbation of chronic diseases of the heart and large vessels;
disorders in the blood coagulation system (thrombophilic complications);
significant shocks and stresses;
multiple pregnancy.

Hormonal and infectious factors, which were given importance in the early stages, fade into the background in the second half of pregnancy. After 20 weeks, the main cause of placental abruption is the pathology of hemostasis. Diseases are of great importance of cardio-vascular system especially in women over 30 years of age.

Symptoms of placental abruption in late pregnancy

The main sign by which one can suspect the departure of the fetal site from the walls of the uterus is bleeding. The intensity of bleeding from the genital tract will depend on the size of the detachment. With partial discharge of the placenta, the discharge will be moderate and even meager. In late pregnancy, this phenomenon occurs quite rarely. Where as more often there is a complete detachment of the placenta with massive bleeding. This development of events threatens the life of the woman and the fetus and requires the immediate help of specialists.

It happens that the placenta moves away from the uterine wall, but bleeding does not develop. An extensive hematoma is formed between the fetal site and the uterus, the blood from which gradually seeps into the muscular and serous layers of the organ. If more than 1/3 of the placenta is damaged, the fetus dies. The only sign of placental abruption in this situation will be the absence of fetal movements for a long time.

How to guess that something is wrong with the baby? A woman feels the first movements at a period of 16-20 weeks. At first, these are timid, barely noticeable tremors every few days. The baby is growing up, and the movements of the fetus are becoming more active. By the end of pregnancy, the baby kicks the mother's tummy several times a day. Over time, every woman notes that the crumbs have their own periods of activity. It has been observed that some children move more in the morning, while others prefer to stay awake at night.

If there are any deviations from the usual movements of the fetus, you should consult a doctor. A decrease or increase in the activity of the child does not always indicate placental abruption. This may be a sign of hypoxia, and in this way the baby signals to his mother that he is not feeling well. The absence of fetal movements during the day after 30 weeks is an alarming sign and can be regarded as a symptom of placental abruption.

Additional diagnostic methods

If a detachment is suspected, all women must undergo an ultrasound examination. During the procedure, the fetal heartbeats are counted. The thickness of the placenta, the presence of calcifications and other changes in it are also evaluated. When a hematoma is detected, its dimensions are measured.

After 34 weeks, cardiotocography (CTG) is performed. This method allows you to determine the number of fetal heartbeats per minute, as well as evaluate their rhythm. At the same time, the state of the muscular layer of the uterus is monitored. The appearance of large Braxton-Hicks waves indicates that the uterus is in an increased tone and is ready to get rid of the fetus at any time.

What threatens placental abruption to a woman?

With partial detachment of the placenta, anemia develops. In the blood, the level of red blood cells falls, which inevitably leads to a decrease in the amount of iron. All these processes threaten to lead to a lack of oxygen, which negatively affects the condition of the child. Anemia during pregnancy can be a direct cause of fetal hypoxia.

In late pregnancy, the discharge of the fetal site ahead of time leads to profuse bleeding. In severe cases, hemorrhagic shock develops. The woman is losing consciousness, and only a team of experienced resuscitators can help her.

Against the background of severe blood loss, DIC often occurs. At this point, mechanisms are launched that prevent normal blood clotting. Disseminated intravascular coagulation leads to the appearance of new episodes of bleeding, which will be difficult to stop.

What threatens placental abruption to the fetus?

The placenta is an important organ that connects the baby to the mother's body. With partial placental abruption, the supply of oxygen and nutrients to the baby is limited. Fetal hypoxia develops, which inevitably affects its development. The lack of oxygen primarily affects the brain, but the rest internal organs experience the effects of hypoxia. Partial abruption of the placenta almost always leads to the development of placental insufficiency and the birth of a child with various developmental pathologies.

Departure of more than 1/3 of the fetal site leads to the death of the fetus. The supply of oxygen to the baby stops instantly, and the further existence of the child in the womb is impossible. You can save the baby only when performing a caesarean section as soon as possible.

A child born after 22 weeks is provided with all the necessary resuscitation measures. Immediately after birth, the baby falls into the hands of neonatologists. A premature newborn is transferred to a specialized department, where he will be looked after by specially trained personnel. As soon as the child adapts to the new conditions of existence, he will be discharged home.

Management of placental abruption in late pregnancy

Preserving therapy is carried out only with partial detachment of the placenta. If the fetal heart beats, doctors try to extend the pregnancy to at least 36 weeks. For this purpose, drugs are prescribed that improve uteroplacental blood flow. Currently, actovegin and its analogues are very popular. The drug is administered intravenously by drip in a course of 5 to 10 days.

In late pregnancy, placental abruption is often associated with pathology of the blood coagulation system. That is why many expectant mothers are prescribed antiplatelet agents. Pentoxifylline and other similar drugs act on platelets, reducing their activity. Antiplatelet agents thin the blood, reduce vasospasm and improve microcirculation in tissues. The course of therapy lasts from 7 to 10 days.

With complete abruption of the placenta, an emergency caesarean section is performed. The duration of pregnancy does not play a role here, we are talking about saving the life of a woman and a child. During the procedure, the vessels are sutured and the bleeding stops. After the operation, the woman is in the intensive care unit for several days. Premature babies are transferred to a specialized department, while babies born after 36 weeks stay close to their mother.

Placental abruption can occur not only during pregnancy, but also during childbirth. This often happens at the birth of the first child from twins, as well as in the case of abnormal labor activity. In this situation, tactics will depend on how far the baby has managed to advance. If the child is already at the very exit, he is helped to be born with the help of obstetric forceps. In all other cases, an emergency caesarean section is performed.