When the birth is approaching, the woman, although she is looking forward to this moment, really wants to convey the baby to the right time. Unfortunately, in the later stages, when it would seem that all pregnancy tests have been completed, complications may arise. One of them is placental abruption. To understand what it is and what threatens mom and baby, you need to figure out what a placenta is.
Authority and its functions
The placenta is a completely unique organ. Firstly, it exists temporarily - only during pregnancy. Secondly, the placenta is considered the organ of the fetus, but we can assume that it belongs to two immediately - the baby and mother. This is exactly the place where the blood of the mother and the fetus meet, but they do not mix due to the placental barrier. The placenta primarily performs nutritional and respiratory functions. Through it, the baby receives the necessary water, vitamins, minerals, glucose, as well as oxygen. Carbon dioxide and waste products of its rapidly growing organism are removed from its body. In addition, it provides immune protection to the fetus. Through the placenta, the antibodies of the mother come to him. But the work of the placenta is important not only for the baby, but also for the body of the woman herself. It produces hormones that help to properly regulate pregnancy, as well as prepare the mammary glands for the upcoming feeding. Dr. Michel Oden called the placenta the baby's lawyer. While, for example, the roots of the plant absorb those substances that are in the soil, the placenta can partly “control” the process, extracting everything necessary from the mother’s blood. Providing the baby with nutrients and oxygen is so important that the placenta can even come into conflict with the mother's body. People say that the child will take his.
True, do not overestimate the capabilities of this body. Otherwise, there would not be lightweight children, toddlers with developmental delays or affected by a deficiency of any necessary substances. In addition, the placenta can not protect the child from the effects of alcohol, nicotine, drugs and viruses. Therefore, pregnant women are recommended to lead a healthy lifestyle and beware of colds and infections.
The structure of the placenta
The placenta has the shape of a disk with a diameter of about fifteen to twenty centimeters and a maximum thickness of 2.5 to 3 cm, to the edges it is somewhat narrowed. By the way, the name of the organ comes from the Latin placenta - a flat cake, flat cake. In the kitchen of some nations, for example, Moldavians, there are cakes of plincind, having a round flat shape. Their name is also akin to the Latin word.
The placenta is attached to the wall of the uterus. Its formation begins already on the seventh day, when the shell of the embryo is formed - the chorion and amnion. Chorion is transformed into a placenta, which at 12 weeks is similar to a round cake with thin edges, and at 16 weeks already formed. Thus, this organ overtakes the formation of the fetus in its development.
The umbilical cord departs from the placenta, in which three vessels are normally located. Interestingly, the arteries and veins here are changing roles. Arterial blood rich in oxygen enters the baby’s body through the umbilical vein. Carbon dioxide and waste products leave his body through two umbilical arteries. These arteries are coiled around a thicker vein.
The placenta consists of lobules densely penetrated by small vessels. The maternal vascular system is connected with the vessels of the uterus, on the part of the fetus it is separated from it by the amnion, so the blood of the mother and baby only exchange substances, but do not mix. After the birth of a child, doctors always examine the aftermath of the mother who has left the body. The two sides of the placenta look different. On the part of the fetus, it is covered with a smooth, slightly grayish shell, and the mother has a pronounced structure of lobules.
Placental abruption
This pathology is the separation of an organ from the uterine mucosa, complete or partial. In the narrow cavity that has formed, blood accumulates, which further repels the placenta from the uterine wall. All this is normal in the third birth period, when the last should come out, but it is dangerous during pregnancy.
Placental abruption at different stages of pregnancy
The duration of pregnancy depends on the danger of the consequences of this phenomenon. In the first trimester, with timely diagnosis and treatment, it may not harm the mother and baby. After all, the placenta is still growing and developing, so its increase in area and volume compensates for damage.
In the second trimester, this is characterized by high muscle tone and tension. Treatment depends on the specific situation and duration. For example, at the beginning of the second trimester, compensation due to the growth of the placenta is quite possible.
In the third trimester, in late pregnancy, the consequences of placental abruption are most serious. This organ already ceases to grow, so the loss of substances coming to the child with blood is no longer compensated. And yet, depending on the amount of damage, there are two outcomes. In some cases, one can not do without delivery, especially a premature baby at such times it is really possible to leave. Under more favorable circumstances, a woman can inform a child before the deadline, however, she will have to go to the hospital for conservation. This happens if the detachment area is relatively small, there is no bleeding and the process does not progress.
Finally, placental abruption can occur during labor, but several hours ahead of time. While normally this should happen only in the third stage, sometimes it happens in the first or second - during contractions or attempts. In this case, doctors can prescribe a cesarean section or stimulate labor. Indeed, even during birth, the baby receives the necessary substances through the umbilical cord, primarily oxygen, and it can suffer from hypoxia. In addition, bleeding can be dangerous for the mother.
Causes of placental abruption
Why does placental abruption occur in the later stages? There is no definite answer to this question.
Violations in the vascular system can make capillaries fragile, this can greatly disrupt blood flow and provoke bleeding. This can be observed with gestosis, as well as with diseases not related to pregnancy, such as diseases of the cardiovascular system, kidneys, obesity, and diabetes.
Degenerative or inflammatory processes in the uterus and in the child's place can become another reason for placental abruption in late pregnancy. This happens, for example, with uterine fibroids or overexposure, when the placenta is aging, and the baby has not yet been born.
This toxin can be caused by toxins that enter the body with bad habits - drinking alcohol, smoking, drug addiction. However, during pregnancy, it is important in any case to abandon bad habits. They entail a huge number of consequences and become the causes of placental abruption in the later stages. Moreover, an improper lifestyle can harm much earlier, causing fetal abnormalities - from prematurity to mental retardation. Only the use of alcohol is questionable: some sources advise categorically to refuse alcoholic beverages and alcohol-containing medicines, while others allow the use of red wine in very small doses. But it's better to play it safe. To live 9 months without wine, which you still can’t drink a lot, is quite real, and the child’s health is worth it!
Anemia also has a pathological effect. True, it is worthwhile to understand that a slight decrease in hemoglobin is acceptable during pregnancy. After all, the amount of fluid in a mother’s body is greatly increasing, so blood can become "diluted."
More often, placental detachment occurs during repeated birth, which is associated with changes in the uterine mucosa. The risk of it increases with multiple pregnancy.
Autoimmune diseases and allergies also provoke it, especially for donated blood and protein solutions. It can also be a dangerous side effect of taking certain medications.
Of course, mechanical damage due to a trauma to the abdomen, which can happen during a fall, household trauma, accident, can also affect.
Also, there are such reasons for placental abruption in the later stages, such as severe physical exertion and emotional stress. Therefore, pregnant women are advised to take care of themselves, and their relatives - to help expectant mothers in everyday life and to avoid conflicts.
In the presence of any harmful factors, it is important to regularly see a doctor, follow his instructions and be attentive to your health.
All these reasons are characteristic for different periods of pregnancy.
Symptoms
The three main signs of placental abruption in late pregnancy, as well as in earlier ones, are bleeding, tension and pain in the uterus and impaired fetal heartbeat.
Bleeding depends on how the placenta exfoliated. If its edge is separated from the uterine wall, the bleeding will be external, visible. In this case, a brownish vaginal discharge will become a symptom of placental abruption in the later stages. If a pregnant woman discovers such discharge, do not consult a doctor. This happens in most cases of placental abruption in late pregnancy, but there are also internal bleeding. If the middle of the placenta is separated, and the edges remain in place, blood accumulates inside as a hematoma, and there is no discharge. This option occurs in 20% of cases. True, in this situation, placental abruption in the later stages will not remain completely invisible. The pain, which is characteristic of this pathology, with internal bleeding is stronger. It may be accompanied by a general malaise - weakness, nausea, dizziness. Such symptoms can occur with any bleeding in the body. The uterus is tense, when you feel the woman feels pain. These signs of placental abruption in the later stages can be of a different nature. The pain may be dull or paroxysmal. It can be felt not in the abdomen, but is given to the thigh and perineum.
Palpitations and movements
It is no coincidence that obstetrician-gynecologists at each examination listen to the baby’s heart rate. Violation of the cardiac activity of the fetus may be evidence of many different pathologies of pregnancy, including placental abruption in the later stages. The severity of the fetal suffering depends on the area of the separated placenta and the amount of lost mother’s blood. If 1/4 of the placenta has departed from the wall, violations in the work of the baby’s heart become noticeable, if 1/3, the fetus experiences severe oxygen deficiency. After all, the placenta carries the child not only nutrients, but also oxygen, and its lack is reflected in the body’s work very quickly. Detachment of half the placenta can be fatal for the fetus.
By moving the fetus, we can assume what is happening to him. With a slight lack of oxygen, the baby begins to move very actively. With these movements, he massages the placenta and stimulates the flow of oxygen-rich blood. If the situation worsens, and hypoxia intensifies, the fetus calms down - he simply does not have enough strength to move. A particularly alarming sign is the lack of movement during the day. After 30 weeks, this is likely to be a symptom of placental abruption in late pregnancy.
Diagnostics
In the presence of suspicious signs, such as bleeding, pain and discomfort in the abdomen, increased tone, changes in the movements of the child, additional studies are carried out. In such cases, an ultrasound is mandatory. This method allows you to learn a lot about the condition of the fetus, uterus and placenta. Several features are evaluated during the procedure. The fetal heart rate is counted. The thickness of the placenta is measured, the presence of changes in its structure is assessed. In the presence of hematoma - a dangerous symptom of placental abruption in the later stages, its size is measured.
After 34 weeks, all pregnant women receive cardiotocography (CTG). It also allows you to measure the fetal heart rate and rhythm. In addition, the state of the muscle layer of the uterus is assessed. Raising it means getting ready for premature birth.
Treatment of placental abruption
If several weeks are left before the birth, it is better to expedite the birth than wait for the unpleasant consequences of placental abruption. In the later stages, early birth is not so terrible.
But in favorable cases, the expectant mother can be put in a hospital. At the same time, strict bed rest is observed. The patient is under day and night supervision of doctors. Regular monitoring of the condition of the child is performed using Dopplerography and cardiotocography. Any deviations may be an indication for urgent cesarean section.
Women who had a placental abruption in their previous pregnancy are sent to the hospital from 36 weeks, even if no dangerous symptoms are observed.
Real people experience
What do women write who have experienced placental abruption in the late stages? Reviews about this pathology are very different. Unfortunately, a significant number of pregnant women have lost their babies. Such women lament that the pathology was discovered too late or not detected at all. Detachment of the placenta threatens the life of the mother - very likely severe bleeding during childbirth. However, modern medicine allows almost all women to survive. Therefore, do not focus on the negative. Positive emotions, even if a pathology is detected, can help safely endure a baby.
Always remember that many children were saved thanks to cesarean section. Moreover, pregnancy with placental abruption in the late stages and cesarean section is not a sentence. Many women with this pathology became pregnant again and gave birth to healthy children without complications. Cases are also common when childbirth with placental abruption took place on time. So you can never lose faith in the best. With careful attention to your condition, you can avoid so many dangerous consequences. And if you go to the doctor on time and regularly undergo examinations for pregnant women, then you can minimize the risk of pathology.