What types of detachment exist?
Having dealt with the fact that such an abruption of the placenta in the current pregnancy, we proceed to the classification of this violation.
So, depending on the time of development, distinguish:
- detachment in the early term (1 trimester);
- at the late term (end of the second and 3 terms);
- in the process of delivery.
After the area of the placenta is assessed, which is exfoliated, the doctor makes a diagnosis:
- complete detachment (the child's place completely disconnects from the uterine wall);
- partial (can be marginal (separates only the edge of the placenta) and central (detachment occurs in the center of the child's place).
- Also, depending on how the process of detachment itself proceeds, one can distinguish such forms of it as:
- progressing (there is an increase in the area of the peeling placenta in a short time);
- non-progressive (when the detachment stops).
Because of what can this complication develop?
As can be seen from the above classification, such a violation of pregnancy can develop both during the period of gestation itself, and directly during delivery. However, this fact does not depend on what caused the violation.
Among the factors that provoke the development of placental abruption, it is necessary, above all, to name the following:
- diseases of the cardiovascular system (increase in blood pressure, for example);
- disruption of the urinary system ( nephritis );
- diseases of the endocrine system (diabetes mellitus);
- the presence in the past of allergic reactions;
- abdominal injury;
- predisposition to thrombosis;
- late gestosis.
Such reasons serve as an explanation of why the detachment can develop during pregnancy. If we talk about this violation, which occurs during the birth process, then, as a rule, it is caused:
- late, untimely rupture of the fetal bladder (with full disclosure of the uterine neck it retains its integrity);
- premature discharge of amniotic fluid, especially with polyhydramnios;
- prolonged stimulation of the uterus, which leads to the so-called hyperstimulation (with the administration of large doses of oxytocin);
- the fetus has a short umbilical cord.
How is the detachment manifested and what are its degrees?
Depending on the type of clinical picture, there are 3 degrees of severity of such a violation, as placental abruption:
- Light form. Its peculiarity is the fact that the general condition of the pregnant woman is not violated. There is a peeling of a small portion of the placenta, which is accompanied by the release of a small amount of blood from the genital tract.
- The average degree is characterized by a detachment of 1/3 of a child's place. With external bleeding, the blood is fairly voluminous, often with clots. There is a pain in the abdomen, an increase in uterine tone. Fetal hypoxia develops, which requires intervention by physicians.
- Heavy degree. There is an exfoliation of 50% or more of the entire area of the placenta. The general condition of the pregnant woman deteriorates sharply, there is severe uterine bleeding, the fetus dies. This condition requires urgent hospitalization.
What threatens to detach the placenta and what to do with its development?
At the appearance of the first symptoms (pain in the lower abdomen, blood from the genital tract, increase of the uterine tone, absence of the movement of the floor), it is urgent to see a doctor.
In order to determine the degree of detachment, ultrasound is performed.
If we talk about what this complication can lead to, then this is:
- hypoxia in the fetus;
- uterine bleeding;
- hemorrhagic shock in women;
- death of the fetus.