About placenta previa was known in ancient times: about the disease mentioned in the works of Hippocrates. Even then, doctors have known that the location of the placenta in the uterus exit is very dangerous to a woman's life, since birth in this case always accompanied by heavy bleeding.
Structure and function of the placenta
The placenta (afterbirth) - a body that exists only in women during pregnancy, providing a link with the mother of the child. After delivery, the placenta moves through the birth canal.
The placenta is a disc with a diameter of about 20 cm and a thickness of 3 cm and attached to the uterine wall on one side. On the other side of the placenta to her umbilical cord attached to the vessels.
Placenta usually located in the rear wall of the uterus. The placenta begins to function fully after I trimester (first three months), reaching full maturity a month before the birth. It carries metabolism
Improves metabolism and losing weight without dieting
between mother and fetus: the gas exchange, the supply of nutrients and removal of metabolic products, providing the body with the mother and fetus hormones and protect the fetus from infections. The placenta also prevents immunological conflict between genetically heterogeneous organisms of mother and child.
What is placenta previa and its species
Placenta previa - the placenta is not attached to the wall of the uterus, in which part of it is in the internal uterine os (the junction of the body of the uterus into the cervix). The incidence of placenta previa is an average of half a percentage point. At repeated pregnancies, this pathology is more common.
There are two main types of placenta previa: total or central (inner cervix is fully closed by the placenta) and incomplete or partial, in which the placenta partially overlaps the opening or its edge is a big part. Incomplete presentation is divided in turn into a side (the opening is not fully closed) and regional (in the uterine mouth is only the edge of the placenta). During labor, the location of the placenta may vary. For example, a complete placenta previa, according to the onset of labor, sometimes gradually transformed into a lateral and lateral to the regional and vice versa.
The most common cause of placenta previa are changes in the state endometrium after abortion, obstructed labor and puerperal infection. Changes in the lining of the uterus prevent the introduction of a fertilized egg in the place of attachment of the ovum, where the placenta is formed. Relatively often with placenta previa in developing additional slices. An important role in the development of placenta previa playing inflammation and proliferation of connective tissue in the decidua (altered endometrium, which is produced during pregnancy and torn away from the placenta after birth).
Placenta previa is manifested mainly uterine bleeding
Uterine bleeding outside of menstruation - a sign of a serious breach
Which usually begin for no apparent reason or due to physical stress, nervous stress. Most often, such bleeding begins in the third trimester of pregnancy (from 24 weeks). The lower the place of attachment of the placenta, the sooner there is bleeding. The majority of women with incomplete placenta previa bleeding begins at birth, with a full - during pregnancy.
Bleeding may periodically break off with decreasing intensity of uterine contractions. At the same time stop bleeding during delivery by partial placenta previa promotes rupture of membranes and intense uterine contractions: the placenta during battle descends, and the presenting part of the fetus presses the separated part of the placenta to the place of detachment, pinches the blood vessels. In cases of complete placenta previa bleeding is usually progressive and can result in hemorrhagic shock - a life-threatening condition.
The most dangerous complication associated with repeated bleeding that can aggravate already developed a state of shock. The source of such bleeding may be the cervix ruptures, which has a lot of blood vessels due to the proximity of the placenta. In postpartum hemorrhage often occur due to lack of uterine contractility in the place of attachment of the placenta.
Placenta previa can be complicated getting into the blood vessels of amniotic fluid, which reduces the rolling properties of the blood (amniotic fluid embolism), and contributes to increased bleeding. The proximity of the placenta to the vagina increases the risk of getting an infection in the blood vessels, which is dangerous for both the mother and the fetus. Detachment of the placenta from the uterine wall will cause oxygen deficiency (hypoxia) in the fetus, which has a negative impact on his condition in the first place, the state of the brain.
Diagnosis and treatment
Placenta previa detected during ultrasound examination, which is conducted during pregnancy several times. A woman is required to warn that even the appearance of small bleeding you need to call an ambulance and go to the hospital. Minor bleeding treated using bed rest, suppression of uterine contractions, as well as the introduction of the drug increases the rolling capacity of the blood and strengthens the walls of blood vessels. With strong bleedings performed caesarean section.
Proper monitoring of pregnant women at the antenatal clinic provides early detection and treatment of placenta previa.