Premature detachment of the placenta

THE placenta it is the organ that provides food and oxygen to the baby during pregnancy. Under normal conditions, the placenta grows in the upper part of the uterus and remains there until delivery. In the third trimester of pregnancy, the placenta separates from the uterus and the contractions help to push it into the vagina. However, this process, called expulsion of the placenta, can occur from the 20th week of gestation, partially or completely. Mild placental detachments are not a problem, but if let go completely prematurely this can prevent nutrients and oxygen from reaching the baby.

Causes of premature placental detachment

The causes of premature placental detachment are unknown, but high blood pressure, diabetes, smoking, cocaine or alcohol use and multiple pregnancies increase the risk of the problem occurring. Premature placental release is the second leading cause of bleeding in the third trimester of pregnancy.

The probability of a woman suffering from this problem ranges from 0.4% to 3.5%. The severe form of detachment occurs in only one in 750 births and causes the baby to die. When the release of the placenta is important (total or almost total), the baby is at increased risk of growth problems. It is also a cause of premature birth and lifeless births.

Causes of fetal death

Most fetal deaths occur in the third trimester of pregnancy. Fetal death is called when the fetus weighing more than 500 grams or after 20 weeks of gestation dies inside the uterus. Some possible causes of fetal death are congenital diseases such as lung hypoplasia, chromosomal disorders, intrauterine growth restrictions, cholestasis, diabetes, pre eclampsia or use of psychotropic drugs (alcohol, nicotine, cocaine) by women.

Symptoms of premature placental detachment

Although the symptoms are proportional to the degree of detachment of the placenta, the most frequent manifestations of the problem are vaginal bleeding, very painful contractions, abdominal pain, uterine hypertonia, abdominal stiffness or distension.

Premature detachment of the placenta without bleeding

The main symptom of premature placental detachment is vaginal bleeding. However, sometimes there is no bleeding as the blood gets stuck in the back of the placenta.

Diagnosis of premature placental detachment

In cases of placental detachment, loss of variability and late decelerations in fetal monitoring tests are usually observed. An ultrasound it is also able to identify detachment. The differential diagnosis of premature placental detachment is to rule out the possibility of a case of placenta previa, uterine rupture or acute appendicitis.

Treatment of premature placental detachment

Treatment will depend on the severity of the placental premature detachment. Thereafter, treatment may vary from rest to an emergency cesarean section.

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