Placenta previa - Causes, Symptoms and Treatment .MF .
First of all, to talk about placenta previa, it is necessary to imagine that kind of authority.Absolutely amazing, detached from both the mother's body, and the body of the fetus, and thus is a bridge between the two, placenta is "live" for a few months, but without it the appearance of a baby light would not be possible.
normal position and function of the placenta
name did not appear by accident, placenta - translated from the Latin - "cake", so we can just imagine her appearance.It has a disk-shaped, soft and crumbly to the touch, the placenta grows throughout pregnancy up to 36 weeks and reaches the size of the average pancake pans.The placenta (synonym - afterbirth) has many functions, the main ones being the power of the developing baby, protection against contact with his body of harmful substances, as well as hormonopoietic.The placenta is an endocrine organ that is formed in it a number of hormones - active substances contribute to the proper operation of the mother's body for carrying a pre
The placenta has two faces: the maternal and fetal.His maternal surface is intimately connected with the inner lining of the uterus and on the surface of the fruit comes the umbilical cord, which carries blood vessels required for the development of the fetal material.Where the umbilical cord attached to the baby's tummy is forever scar reminding us that we all come from the "placenta".
In normal pregnancy, the placenta is usually located in the uterus, with the transition to the rear and side walls.Less commonly, it is located on the front wall, and this is no accident.The front wall of the uterus is subjected to much greater transformation than the back.Thus, the preservation of nature has taken care of pregnancy.In addition, being located close to the abdominal wall, the front wall of the uterus is exposed to accidental injury.Do not forget that the main role of the placenta - the transfer of nutrients and oxygen from the mother's body to the developing fetus in the womb, and nutrients are distributed throughout the body through the blood vessels.It is for this children's place and is located in the uterus perfused in most places.
During labor uterine contractions, expelling the fetus after birth, leading to disruption of intimate connection between the uterus and the placenta and the last born during the successive period (III stage of labor), which lasts from a few minutes to half an hour depending on tacticsbirth, adopted in the maternity hospital.Subsequent includes placenta with fruit shells.
degrees of placenta previa
is not at the right place, the placenta interfere with the normal development of the pregnancy.The term "placenta previa" includes all the pathological variants of its location in the uterus from the attachment in the lower segment to the complete overlap of the internal uterine os.Despite the variety of options, allocate 3 basic degree of misplaced:
• lower placental edge is less than 7 cm above the inner throat, but did not reach him
• the lower edge of the placenta reaches the borders of the internal uterine mouth or the placenta partially covers his
•complete placenta previa.
Most often, this pathology occurs in multiparous women, when repeated many times abortion and other intrauterine operations in patients after an inflammatory disease of the uterus (endometritis).Significantly increases the frequency of this disease in the uterus myoma.
diagnosis of placenta previa
Today diagnosis of placenta previa is not difficult.This abnormality is detected by screening ultrasound during which can accurately determine the localization of the placenta into the uterine cavity, as well as other important features such as thickness, structure and characteristics of blood flow, etc.In addition, there are a number of clinical signs suggestive of an abnormal location of the placenta, which is called "arms".
First of all - this is a long distance high fetal presenting part above the entrance to the pelvis in late pregnancy, malposition, bright red painless bleeding from the genital tract, especially the often repeated.
course of pregnancy in this type of pathology is often complicated by the threat of interruption, malposition in the uterus, as well as the development of placental insufficiency and fetal growth retardation.High risk of bleeding.Moreover, in contrast to the bleeding associated with other causes during pregnancy, it carries a painless character with placenta previa.
Treatment of placenta previa
drastic methods of treatment of this pathological condition does not exist.It is not possible to "transplant" the placenta to another more suitable place.However, the hearing at a reception at the gynecologist phrase "presentation" or "low position of the placenta" should not be panic.Medicine today has sufficient funds to help the development of pregnancy, even when properly disposed placenta.And the main point is the dynamic monitoring by a doctor in the antenatal clinic.
There is such a thing as "placental migration".Of course, by itself the placenta does not move, however, once in adverse conditions, that is implanting in places with poor blood flow, it often grows to the bottom of the uterus, where the blood supply is significantly better.In addition, the muscle wall of the uterus undergoes significant changes during pregnancy, and the layers of the "moves" in the upper sections of the uterus, with them there is the removal of the placenta from the internal os.These changes are most pronounced in the front wall of the uterus, as mentioned above.Thus, the location of the placenta on the front wall of the uterus worsens the prognosis in terms of its adequate blood supply, on the other hand there is a greater chance that the placenta is "migrating", due to changes in the structure of the wall.
complications of placenta previa
The most severe complication of placenta previa is its detachment, causing severe bleeding may occur from the opened uterine vessels, which is often only possible to stop the emergency delivery by cesarean section.In addition to women's health, detachment of the placenta previa when it also endangers the life of the fetus.The greater the detachment surface, the greater the risk of major bleeding, and the stronger the fetus suffering from lack of oxygen and nutrients.Unlike other kinds of disease - premature detachment of normally situated placenta - in the case of bleeding previa always outside, that is, the blood does not accumulate in the uterine cavity, and flows out through the cervical canal in the neck.At the slightest suspicion of placental abruption woman should be urgently hospitalized in the nearest maternity hospital.If the pregnancy is not suggesting a willingness to leave the baby and extrauterine life (up to 35-37 weeks), the patient's condition and the baby is satisfactory, the amount of bleeding is small, perhaps an extension of pregnancy drug methods.Women prescribed bed rest, hemostatic drugs, drugs that reduce the tone of the uterus (tocolysis).During fetal condition dynamically observed by monitoring the number of perturbations, which is very patient, cardiac monitoring hardware fetus.You may need the appointment of glucocorticoid hormones to prepare the baby to the light of life outside the womb with the threat of premature birth.If the woman's condition is extremely serious, even with short term pregnancy is terminated for health of the mother.
Given the threat to the above complications, a woman whose pregnancy is placenta previa in the background, you must observe the following rules.Houses she should avoid excessive exercise, heavy lifting, jumping, shaking, you may need to limit sex.
necessary to avoid a long and distant travel, even if the road conditions are excellent and shaking excluded.Aviapereezdy from the sharp changes in atmospheric pressure are also contraindicated.Relatives and friends have to help a pregnant woman to meet these conditions, in addition, they need to know in advance in which hospital you need to be hospitalized in the development of its complications.Setting a pregnant woman should contribute to the emotional calm and reduce stress influence.
Childbirth with placenta previa
approach to delivery is always individual.In the absence of other obstetric complications, and other somatic diseases, satisfactory condition of the patient, in case of low attachment of the placenta may elective delivery vaginally, that women more often referred to as a "bear itself."The delivery is carried out continuous monitoring of the general state of the mother, the volume of bleeding, hemodynamic parameters (heart rate, blood pressure), intrauterine fetus and indicators of labor.urgent laboratory tests, ultrasound may be performed if necessary.With the development of complications of major bleeding, as well as the complete placenta previa can only be operative deliveries (cesarean section).
Regardless of the presence of certain complications of pregnancy you should always follow the advice and recommendations of experts.It is necessary to remember that even the best doctor can not help you if you do not want.
Obstetrician-gynecologist Nikulichev Dmitry V.