Causes of placental detachment

Placental detachment may be caused by vascular diseases, especially gestational hypertension and chronic kidney disease, or it may be caused by mechanical factors, which will cause the uterus to contract and affect the normal development of the fetus and make delivery difficult. Now let us understand the causes of the symptom of placental abscess.

What causes placental abscission?

First, vascular disease: Pregnant women with placental abruption often have complications such as severe pregnancy-induced hypertension, chronic hypertension and chronic kidney disease, especially those who already have systemic vascular disease. When the spiral arterioles of the decidua basalis spasm or sclerosis, it causes ischemia and necrosis of the distal capillaries, resulting in rupture and bleeding. The blood flows to the decidua basalis layer to form a hematoma, causing the placenta to detach from the uterine wall.

Second, mechanical factors: trauma (especially direct impact to the abdomen or falling with the abdomen directly touching the ground, etc.), external version to correct the fetal position, the umbilical cord is too short or the umbilical cord around the neck, and the descent of the fetal presenting part during delivery may all lead to placental abruption. In addition, if the first fetus in a twin pregnancy is delivered too quickly or there is too much amniotic fluid and the amniotic fluid flows out too quickly when the membranes rupture, the intrauterine pressure will drop suddenly and the uterus will suddenly contract, which may also cause the placenta to detach from the uterine wall.

Third, a sudden increase in uterine venous pressure: In late pregnancy or after delivery, supine hypotension syndrome may occur when pregnant women lie in the supine position for a long time. At this time, the huge pregnant uterus compresses the inferior vena cava, which reduces the amount of blood returning to the heart and causes a drop in blood pressure. However, the uterine veins become congested and the venous pressure increases, leading to congestion or rupture of the decidual venous bed, causing partial or complete detachment of the placenta from the uterine wall.

What are the symptoms of placental abscess?

First, mild type: It is most common during delivery, with symptoms including external bleeding and up to one-third of the placenta detaching. Accompanied by mild abdominal pain, heavy and dark vaginal bleeding, and no obvious anemia symptoms.

Second, sudden and persistent abdominal pain, back pain, etc. The larger the area of ​​placental detachment, the stronger the pain; the larger the amount of blood accumulation, the stronger the pain. In severe cases, symptoms such as vomiting, cold sweats, and low blood pressure may occur, leading to shock. Vaginal bleeding may occur sometimes and not, sometimes less and sometimes more, but the severity of anemia symptoms in pregnant women does not correspond to the amount of bleeding. There may sometimes be invisible bleeding, and the placenta may be detached in more than one-third, accompanied by severe hematoma.