Placental Abruption: What Are The Dangers For Mother And Child?

One of the biggest bugbears of early pregnancy is premature placental abruption. The placenta, the placenta is vital for the baby. It provides the fetus with all the nutrients and oxygen it needs.

After birth, the placenta is normally expelled.

The Birth And Normal Placenta Detachment

Childbirth can be a lengthy process. Especially for first-time mothers, labor often continues for many hours.

During the birth process, the placenta is still needed to feed and care for the baby. Within the first half hour after your baby is born, the placenta normally detaches.

Postpartum contractions cause the uterus to contract and the placenta to slide into the birth canal. Together with blood, the placenta is expelled and the blood vessels close.

This process usually takes between 20 and 30 minutes.

Your midwife can check if the placenta has already detached. If you are having difficulty with the afterbirth, you can push during the pushing contractions and speed up the process.

Your midwife can support you by gently pulling on the umbilical cord. This process is no longer painful for you.

Danger: Delayed Placental Abruption Carries Risks

Once the placenta has been expelled, it will be carefully checked by your midwife. The placenta must have detached completely; tissue residues can lead to secondary diseases:

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If the placenta detachment does not work naturally, a curettage must be performed.

This Is How You Can Help With Placenta Detachment

If you are one of the mothers who is waiting for the afterbirth, you should stay relaxed for the time being. In some cases, especially in first-time mothers, it can take up to 1.5 hours for the afterbirth to be completed.

There are measures that can be taken to stimulate placental abruption.

  • Putting the baby to the breast to stimulate the release of the hormone oxytocin. This hormone causes uterine contractions.
  • Emptying your bladder. An overfull bladder can delay postpartum. Your bladder can be emptied with the help of a catheter.
  • Massage of the uterus. With a skilled grip, the midwife can massage your uterus to induce contractions.
  • Use of a contraceptive drip. If the afterbirth does not occur on its own, a labor-inducing hormone may be helpful.

Manual Placenta Abruption Only In Exceptional Cases

Only if all other measures are of no use and the afterbirth cannot be induced, the placenta must be detached manually.

You will not be aware of this procedure because you will be given a general or peridural anesthesia.

The attending gynecologist will feel for the placenta with his hand and carefully detach it. If there are no adhesions, the afterbirth can be induced with it.

If there are adhesions, a scraping is still performed under anesthesia.

Premature Placenta Detachment – Rare But Highly Risky

One of the greatest risks in early pregnancy is premature placental abruption. At 0.5 percent of all pregnancies, this complication is very rare but consequential.

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In early pregnancy, your baby is not yet viable on its own. If the placenta detaches at this stage, the metabolism between your and your baby’s circulatory system is interrupted.

The premature detachment of the placenta leads to an undersupply of the baby. In early pregnancy, the risk of miscarriage is high.

If the pregnancy is already advanced and the unborn child is viable, premature placental abruption usually results in induction of labor.

Important: Premature placental abruption has a recurrence risk. The event repeats in five to 15 percent of all affected women.

The Causes Of Premature Placental Abruption

There are a lot of causes that lead to a premature detachment of the placenta. You cannot influence all of them yourself, but regular medical check-ups are the best precaution. The following causes can be considered.

  • External force from a bump, fall or accident.
  • Severe fluctuations in blood pressure.
  • Myomas inside the uterus.
  • Placental insufficiency.
  • Pre-eclampsia.
  • Risk pregnancy due to high maternal age.

Attention: This Is How You Recognize An Impending Placental Abruption

The severity of the symptoms of placental abruption depends on the extent of the abruption. You will not feel the detachment process itself, and it often takes several hours before symptoms appear.

If you fall, for example, you should always consult a doctor in order to recognize a later placental abruption in time.

You can recognize the complication by these symptoms.

  • Bleeding from the vagina.
  • Hard, painful abdomen.
  • Signs of shock (high pulse, low blood pressure).
  • Severe pain, contractions.
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If you experience any of these symptoms, you should consult your gynecologist. An ultrasound examination can reliably detect premature placental abruption.

How Does The Doctor Treat Premature Placental Abruption?

If premature detachment of the placenta occurs, you must act with utmost urgency. If you suffer from severe blood loss, your doctor will provide you with blood units

The birth of your child must be started immediately in order to ensure its nutritional supply. If your unborn child has already died in the womb, doctors advise you to deliver it naturally.

What Is An Anterior Placenta?

Anterior wall placenta is not a dangerous complication and is harmless in most cases. This term is used when the placenta is located in the front of your uterus.

An anterior placenta can cause you to not feel your baby’s kicks as much as other moms.

Every placenta sits differently, there are just statistics about how often it is placed. For example, the placenta sits in the upper third of the uterus for most mothers.

This has the advantage that the placenta does not block the birth canal during the birth process. Your doctor can tell whether you have an anterior placenta by ultrasound in early pregnancy.

However, an anterior placenta is not a rare phenomenon. It forms when the fertilized egg nests in the uterus in the area behind your belly button.

With an anterior placenta, your baby will be just as well cared for as if it were in any other position.

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What Is Placenta Praevia?

A more complicated shift in the position of the placenta is called placenta praevia. Here, the placenta sits very close to the cervix, in the lower part of your uterus.

Since the placenta occupies a larger space than the lower part of the uterus offers, there is a risk of bleeding.

There are two types of placenta praevia. If the entire cervix is covered with placental tissue, physicians speak of placenta praevia totalis.

If the end of the placenta only reaches down to the cervix, this is called placenta praevica marginalis.

Why Does Placenta Praevia Develop?

There are several causes that promote the development of placenta previa. These include:

  • Multiple pregnancies.
  • Frequent cesarean sections.
  • Age of the mother over 40.
  • Previous uterine surgery.
  • Smoking during pregnancy.

During an ultrasound examination, the gynecologist can see the position of the placenta already in early pregnancy. However, there is no reason to worry in early pregnancy.

The placenta can still shift throughout the duration of pregnancy. Only when vaginal bleeding occurs can this be a warning sign.

How Is Placenta Previa Treated?

Unlike a harmless anterior placenta, placenta previa is associated with dangers. The biggest risk with late placenta previa is premature placental abruption.

There is also a risk of bleeding. The deeper the placenta is in the abdomen, the more closely you need to be monitored by your doctor.

Doctors often prescribe bed rest in the second trimester of pregnancy to prevent premature placental detachment. For safety’s sake, delivery is almost always by cesarean section.

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