Premature placenta detachment

At a premature placenta detachment (abruptio placentae) it is a very serious complication during pregnancy that acutely endangers the life and health of the unborn child as well as the mother.

What is premature placenta detachment?

As a rule, when an occurrence is detected, a premature placental detachment the fastest possible introduction of a caesarean section if the child is already viable. Statistically speaking, premature placenta detachment occurs in less than one percent of all natural pregnancies.

Premature placenta detachment occurs when the so-called placenta - which is used to supply the unborn child with nutrients - is either partially or completely detached from the uterus before the child is born.

The detachment results in uterine bleeding, i.e. Bleeding in the womb.These in turn lead - if left untreated - to a shock due to blood loss (hemorrhagic shock) in the mother and to an acute undersupply of the unborn child with oxygen (hypoxia) up to the death of the child due to a lack of oxygen.

causes

The cause of a premature placental detachment For example, it can be a very violent bump or blow to the abdomen, which is suffered as part of a fall on stairs or a car accident.

Premature rupture of the bladder - i.e. Premature rupture of the amniotic sac before labor begins - can cause premature placenta detachment. High blood pressure (hypertension) is considered to be a favorable factor, which is why pregnant women who suffer from high blood pressure are exposed to an increased risk (including other complications).

The likelihood of premature placental detachment increases with the number of previous pregnancies; the personal risk increases - statistically speaking - with every additional child.

Symptoms, ailments & signs

Premature placental detachment affects women before they have one or more children. In a third of all cases, there are no symptoms at all. The detachment can then only be detected with an ultrasound device. It is extremely low. In addition, advanced and strong forms can be distinguished that show typical symptoms.

With advanced detachment, women complain of tenderness in the abdominal area. The lower abdomen is particularly affected. Pain occurs suddenly without any apparent cause. With this form of placenta detachment, small amounts of bleeding appear from the vagina, also known as spotting.

The intensity of the bleeding indicates the degree of detachment. A profuse leak of blood from the vagina indicates a pronounced shape. The pain in the stomach area is then severe. They are constant and continue to intensify. If there is a large blood loss, shock and coagulation disorders are typical.

Most pregnant women are fearful. The heart rate increases. The premature detachment of the placenta, in its most pronounced form, also affects the unborn child. This suffers from a lack of oxygen. The heartbeat changes abnormally. In rare cases, it even dies in the womb.

Diagnosis & course of disease

A premature placental detachment is almost always associated with sudden, severe pain in the abdomen and is often associated with heavy bleeding, a significant palpitations and severe circulatory problems.

The fact that there is a problem is therefore usually noticed immediately, so that in almost all cases of premature placenta detachment, first aid is provided in the hospital quickly. The confirmed diagnosis is made there either on the basis of an ultrasound examination or a coagulation examination (of the mother's blood).

Premature placenta detachment endangers both the life of the unborn child and the life of the mother - while around one percent of affected mothers lose their lives, the probability of losing the child is between 10% and 50%, depending on the week of pregnancy and the child's weight.

Premature placenta detachment is a very rare pregnancy complication, but it has the highest mortality rate of all common complications during pregnancy.

When should you go to the doctor?

The detachment of the placenta can naturally only occur in sexually mature girls or women who are pregnant. In principle, if a pregnancy is determined, a doctor should be consulted and worked with. In the growth process of the fetus, expected and possible developments in the course of the entire pregnancy and childbirth must be discussed. The mother-to-be should inform herself extensively about the upcoming changes and take the necessary precautions for the delivery process. Due to the multitude of complications and adversity, childbirth should under no circumstances take place without the presence of a medical nurse. An inpatient birth is generally advisable, as the best possible medical care is provided in the event of disorders.

Particularly when assessing a high-risk pregnancy, a hospital should be visited at the latest when labor begins. If there are irregularities or abnormalities during the birth, this is monitored by midwives, nurses or doctors present. They react immediately so that no life-threatening situations arise for mother and child. In the event of spotting, unusual pain or unanswered questions, the medically trained obstetricians should be consulted during the entire pregnancy and especially during the birth. The better existing complaints can be described, the faster the cause of the irregularities can often be documented.

Treatment & Therapy

As already mentioned at the beginning, in the case of an already viable child, if the diagnosis is confirmed, an immediate caesarean section is almost always performed, during which the child is surgically removed from the uterus.

If, on the other hand, the child is not yet viable, i.e. kick the premature placental detachment Before the end of the 34th week of pregnancy or if the fetal development is delayed, attempts can be made to reduce labor with medication in order to delay the required caesarean section until the unborn child has reached viability (especially with regard to lung maturity).

prevention

The ways of preventing a premature placental detachment are low. As already mentioned, the presence of high blood pressure in the mother is considered an essential influenceable risk factor. If the problem is known, this can be treated either with medication or conventionally (reduction in body weight, change in diet, targeted physical activities) in advance of pregnancy.

In addition, the risk of premature placenta detachment increases with the number of previous pregnancies, which is why mothers at risk are sometimes advised not to have another pregnancy.

Furthermore, during pregnancy - but also for other health reasons - physically stressful or dangerous activities should be avoided as far as possible, which could lead to trauma in the abdominal area and thus triggering premature placenta detachment.

Aftercare

Premature placental abruption during pregnancy is always an intensive care emergency, as the lives of mother and child are at risk. There is profuse internal bleeding and the placenta and uterus often have to be surgically removed. Because of the many possible complications, follow-up care is very important after a premature placenta detachment.

Excessive blood loss can make the affected woman very weak and lead to anemia. As part of the aftercare, it must be checked whether the body has already recovered from the blood loss or whether further measures are necessary. Follow-up care is particularly important in the case of a caesarean section and the eventual removal of the entire uterus in order to control the wounds that have occurred postoperatively.

The wound healing is assessed during the aftercare as well as any pain, the cause of which can be further investigated via ultrasound. Premature placenta detachment is a serious emergency that makes it particularly important that those affected keep their appointments for follow-up care after the event. Further, sometimes life-threatening complications such as renewed internal bleeding or delayed wound healing can usually be avoided through close follow-up care, but they require the patient's cooperation.

You can do that yourself

Premature placental ablation is a medical emergency. After a fall or signs of placenta detachment, the first step is to call emergency services. Then the woman concerned has to lie down quietly. The ambulance doctor must be informed about the situation. Treatment in the hospital is then necessary. The most important thing to do is to remain calm and inform the doctor at the hospital about the incident as thoroughly as possible.

Since premature placenta detachment is often fatal, affected women often also need therapeutic support. This can be supported by discussions with the partner and other affected persons. Attending a self-help group or registering in an internet forum for affected parents can also be helpful measures.

In addition, any pain that occurs in connection with the detachment of the placenta must be treated. It is important to take the prescribed pain medication. At best, this should be monitored by the partner or a relative, as the women concerned are usually in a shock situation. After completing the treatment, you should have another conversation with the gynecologist and a therapist, in which open questions are clarified.