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Premature detachment of a normally located placenta


Causes: maternal vascular diseases (severe forms of late toxicosis, hypertension, nephritis, etc.), inflammatory and dystrophic changes of the uterus, its overdistension (polyhydramnios, multiple fetuses, large fetus), degenerative changes in the placenta (prolonged pregnancy, hypovitaminosis). The accumulation of blood between the exfoliating placenta and the uterine wall leads to the formation of a retroplacental hematoma. If blood penetrates between the wall of the uterus and the membranes, then external bleeding occurs.
Symptoms and course:
A small stable hematoma may not manifest clinically. With minor bleeding, a pregnant woman (woman) has severe abdominal pain, the uterus becomes dense, the abdomen is swollen and painful in the area of ​​the hematoma. Blood pressure decreases, pulse speeds up. With external bleeding, the degree of anemia does not correspond to the degree of blood loss. The fetus quickly develop intrauterine asphyxia.
Treatment:
During childbirth, the fetal bladder is opened, obstetric forceps or a vacuum extractor are applied. In the third stage of labor, manual separation and excretion of the afterbirth are performed, without waiting for his independent birth due to the danger of hypotonic hemorrhage. With severe bleeding and the absence of conditions for natural delivery, a cesarean section is shown even with a dead fetus.