Diseases of the placenta

Synonyms

Diseases of placenta

Also read:

• placenta

introduction

Since the placenta ensures nutrition and the supply of oxygen to the child, diseases of the placenta that are associated with a loss of function lead to inadequate child care.
The circulatory disorders can be on the maternal as well as on the child's side. An incorrect position of the placenta can also lead to complications, especially during childbirth. The most important clinical pictures are briefly outlined below:

Read more on this topic: Childbirth complications

Placental insufficiency

This is a functional weakness of the placentawhich manifests itself in an inadequate supply of oxygen and nutrients to the child.
One distinguishes one chronic from one acute form placental insufficiency. The latter becomes noticeable within hours and is treated by removing the triggering cause.
A known trigger is the obstruction of a large vein through the heavy uterus (Vena-Cava Compression Syndrome), as well as complications of the umbilical cord or placental abruption as well as placental bleeding or a storm Labor pains.

The chronic form placental loss of function develops over weeks to months. It represents the sequence of several previous changes and is noticeable in a reduced size of the usable exchange surface of the placenta. There are three main changes and deficiencies that lead to such a loss of function of the placenta.

On the one hand, small interruptions in the blood supply (Infarcts) to a breakdown of placental tissue, reducing the surface area. The lack of development of children's vessels within the villi (Avascularity) comes into consideration as the cause and has the consequence that the mother's nutrients cannot pass into the child's bloodstream and thus also lead to malnutrition in the child.
In addition, deposits of a substance are Coagulation systemcalled fibrin is known as an alteration. These deposits cause the blood to clot in the space filled with maternal blood.
As if there is also a reduction in the exchange surface. These three major chronic changes in the placenta can be caused by maternal conditions such as anemia (anemia), Infections, high blood pressure (hypertension), Diabetes mellitus, a kidney disorder (Renal failure) or benign muscle ulcers of the uterus (uterus myomatosus).

Read more about the topic here Pregnancy Complications - What Are The Signs?

But also diseases within the pregnancy or certain pregnancy processes are known as causes. These include abortions, blood intolerance between mother and child, pregnancies in rapid succession, a very young maternal age (under 18 years) or a high (over 35 years) and a low-protein diet.
Also multiparous or mothers who smoke or alcohol Drinking or consuming drugs show a significant increase in a poorly formed placenta.

The therapy of a chronic dysfunction of the placenta consists in the treatment of the diseases mentioned above or in the elimination of the harmful substances.
The child must be observed at close intervals and should there be an acute lack of oxygen, delivery must follow as quickly as possible.

The following article may also be of interest to you: Vena-Cava Compression Syndrome

Disorders of the maternal blood flow

In order to achieve optimal care for the child, a sufficient amount of functioning blood flow in the mother, especially in her uterus, is essential.
A well-known low blood pressure (hypotension) the mother lead to a reduced blood supply to the uterus and thus also to an undersupply of the child. What is more worth mentioning, however, is the fact that primiparous women usually did not have as good blood circulation compared to multiparous women uterus exhibit. The contraction of the uterine muscles under a contraction also leads to a momentary interruption of the blood flow and thus to a temporary lack of oxygen for the child.
Usually they are Labor pains but characterized by not all ’too long and short-term interruptions so that the child does not suffer any harm. Treated as such a disorder depending on its cause.

Placenta misalignment

Sits the placenta too deep in the uterus, the placenta can obstruct the birth canal. In this case it becomes a normal birth through the Scabbard impossible.
Most of the time, because of the obstruction of the placenta, the child lies diagonally, at an angle or in Breech position in the uterus. Such an incorrectly deep-seated placenta is called Placenta previa. Risk factors that lead to such a transfer through the placenta are the old age of the mother, several previous births, earlier Caesarean sections (Sectio ceasarea), Multiple pregnancies and scrapings (Curettages) and Blood group incompatibilities (Erythroblastosis).
Also the Consumption of cigarettes the mother in particular from over 20 cigarettes per day shows significant accumulations of placenta previa and is considered an important risk factor. A placenta previa becomes noticeable through varying degrees of mostly painless bleeding, especially in the last trimester of pregnancy.
The cause of the bleeding is the deformations and enlargements of the uterus and the cervix in preparation for the birth. As a result, the deep-seated placenta is loosened somewhat, which is why there is bleeding from the vagina.
The exact position of the placenta and its deeper seat is determined within an ultrasound examination. Pregnancies in which a placenta previa is detected are usually after the 37th week of pregnancy with a Caesarean section delivered. If the pregnancy is still ahead, bed rest will be ordered and the woman will be admitted to the clinic, avoiding any stress. It will mostly be too Medication which prevent the uterus from contracting and thus prevent further bleeding.

Premature release of the placenta

Here the properly sitting placenta (placenta) suddenly comes off partially or completely. The causes of such a solution are still unknown; changes in arterial blood vessels are discussed, which lead to a separation of the adhesive surfaces on the uterine layer, as well as injuries to the stomach or changes in pressure.
Women with a prematurely detached placenta experience pain. These can take on the whole range from pain to the touch to pain in the back to annihilated abdominal pain. Here, too, there is bleeding. In a quarter of the cases, however, these are hidden and are therefore not noticed immediately.
After the detached placenta has been detected with the help of an ultrasound and the doctor has made a picture of the extent of the detachment, the child must be continuously monitored to ensure an adequate supply of oxygen.
Here, too, the pregnant woman is admitted to the clinic and examined there again and again in order to detect any loss of blood in good time. Taking into account the maternal and child's condition as well as the child's maturity, a caesarean section is carried out as early as possible or the pregnancy is monitored in order to give the child more time for the development of the lungs.

Read more about this under: Premature placental detachment

Placental causes of complications during childbirth

Retention placentae

Here the Postpartum phase the normal duration of 30 min. and with it the normal blood loss of 300 ml.
This withheld placenta The cause can either be an entrapment in the uterus due to a stuffed one bladder or have excessive contraction of the uterine muscles.
Also due to a prolonged birth process, the force generated by the muscles is no longer sufficient to loosen the placenta. Likewise, malformations of the placenta can lead to a delayed postpartum phase.
Following the diagnosis of such a retained placenta, one can first wait to see whether it will naturally resolve in the following half an hour. If this is not the case, depending on the cause Medication given for muscle relaxation or urination. In addition, the placenta can be loosened in most cases with the help of a certain movement by the obstetrician. Should this also not succeed, an instrumental intervention is necessary.

Rebleeding

If there is excessive blood loss of more than 500 ml when the placenta is dissolved, it is usually atonic rebleeding.
This occurs after an overstretched uterus, for example after multiple births or an excessive amount of amniotic fluid. As a result of this overstretching of the muscles, phases of relaxation occur again and again, during which the vessels are not closed, which increases blood loss.
To treat one of this increased bleeding, various medications are given that cause the blood vessels to close, or the obstetrician breastfeeds them by pressing and plugging the blood vessels.

Learn more at: Placental detachment after childbirth