Premature separation of a normally situated placenta

Premature separation of the placenta is one of the dangerous complications of pregnancy when the placenta separates early (before childbirth).

Placental abruption is most likely to occur in the last trimester of pregnancy, especially in the last few weeks before birth

Premature separation of the placenta is divided into:

  • Partial premature separation of the placenta
  • Complete premature placental abruption

Premature separation of the placenta can begin both before and during labor.

The reasons can be:

  • pathology of vessels of the placenta and uterus with various complications of pregnancy, chronic maternal diseases
  • Chronic high blood pressure (hypertension)
  • high blood pressure during pregnancy, resulting in preeclampsia or eclampsia
  • Collapse or birth stimulation
  • abdominal trauma
  • rapid simultaneous discharge of amniotic fluid, which leads to a sharp decrease in intrauterine pressure

PONRP is manifested by pain, bleeding from the vagina.

Sometimes bleeding from the vagina may not be due to the formation of retro-placental hematoma. But the tension, soreness of the uterus is preserved. First of all, the fetal heartbeat begins to suffer. Hemodynamic parameters of a pregnant woman – increased heart rate, may decrease blood pressure.

Maintaining depends on the size of separating placenta.   When it is small with no signs of progression, then the  pregnancy and childbirth can proceed normally.

With the progression of separation or large areas of separation of the placenta from the uterine wall – urgent abdominal delivery is necessary regardless of the duration of pregnancy

In the case of complete separation of placenta and large blood loss, the condition of the pregnant woman is complicated by shock, and can lead to a life-threatening complication – disseminated intravascular coagulation syndrome. The intrauterine fetus dies at the complete separation of the placenta.

All activities should be aimed at combating shock, emergency delivery, stop bleeding, transfusion of blood and its components. In severe cases, with a large blood loss, when bleeding from the uterus does not stop, DIC syndrome has developed, it is necessary to perform a hysterectomy. Comprehensive measures should be directed to the treatment of DIC, which can be a threat to the life of the mother.