Phenomenal Placenta Praevia

During pregnancy, mothers want nothing more than good health, normal child development and a smooth and safe delivery. However, sometimes a few incidents still occur unexpectedly.
Phenomenal placenta praevia
The placenta praevia is a condition where the placenta does not attach completely to the front and back of the uterine bottom as usual, but part or all of the placenta attaches to the lower part of the uterus.
The placenta praevia can cause bleeding in the last three months of pregnancy, during labor and postpartum period, and it can cause difficulty in delivery or poor fetal adjustment, which can affect the health of the placenta. mother and son

.
Classification of disease
Depending on the position of the edge compared to the hole in the cervix, there are many different forms of different forwards:
Low placenta: Most placenta clings to the body of the uterus, only a part of the placenta attaches to the lower part of the uterus, but the placenta does not spread to the hole in the cervix. This type rarely shows out, causes little bleeding or only minor bleeding, often causing early amniotic rupture.
Side placenta: Most placenta clings to the lower part, but the edge of the placenta has not reached the hole in the cervix, this type bleeds slightly, recurs during pregnancy From the edge of the placenta to the tearing amniotic sac, the fetus is smaller than 10cm.




Placenta plaque: Also known as placenta plaque, the edge of the placenta is close to the edge of the cervix, this type bleeds a lot. During labor, the cervix opening can feel the edge of the placenta.
The semi-central placenta or the incomplete central striker: When the cervix is fully open, a part of the placenta covers the hole in the cervix, can feel the amniotic membrane and touch the placenta. This type causes a lot of bleeding and interferes with the birth path.
Center placenta completely: The placenta covers the entire hole in the cervix. Vaginal examination only sees each other, does not see the placenta. This type of intense bleeding, requiring surgery even to give up the child to save the mother's life
Reason
The exact cause of each striker is unknown.



However, often met strikers in women:
- Older age: 1% for women over 35.
- Polygenesis: 1/179 (0.56%) cases of placenta praevia for women giving birth 3 times; 2.2% had placenta praevia for women giving birth more than 5 times.
- History of abortion, miscarriage.
- Uterus has old surgical scar. Many studies show that there is a close relationship between the number of caesarean sections and placenta praevia: the risk of placenta praevia in uterus without cesarean section is 0.26%, but this rate may increase to 10% if a cesarean section is performed.




- History of metritis.
- Do pregnant women use tobacco or breathe in cigarette smoke during pregnancy.
- Uterine malformation.
- Each striker can combine with each other to set the teeth. The frequency of placenta praevia combined with combed teeth increases with the number of cesarean section.
In women without previous incisions, placenta praevia combined with the teeth comb accounted for 9.4%, but in people with a cesarean section, the frequency was 21.1%, if there were two cesarean section This is 47.



6%.
However, there are also cases when the comparison does not have a history of gynecological abnormalities also have placenta praevia. In these cases, it is thought that, because the fertilized egg implant is low, near the waist, so it will develop in the lower part of the uterus.
Pathology
In each striker:
- The placenta is often wider and thinner than usual, so it is easy to have complications of incomplete detachment, causing bleeding in the placenta.
- The placenta near the placenta is often thick and less elastic, so it is easy to break early amniotic fluid.
- The umbilical cord may not cling to the center of the placenta but will usually stick close to each other at the end of the hole in the cervix. Therefore, when amniotic sac rupture, it is easy to prolapse.
- The segment of the uterus is thin, without a muscular network so it is easy to bleed after placenta.




- The fetus is usually not well calibrated due to obstruction by the placenta. Frequently high head. The ratio of abnormal seats such as the horizontal one, the buttock is also very high.
Symptom
Vaginal bleeding is the main symptom, usually occurring in the last 3 months of pregnancy, characterized by a sudden, unexplained, asymptomatic symptom, not accompanied by abdominal pain, bleeding. Bright red after going out with blood clots.
The amount of blood is usually small at first and stops spontaneously, but then relapses again and again and the tendency to lose more and more blood.
In some special cases, the placenta sticks close to the hole in the cervix and does not bleed until labor has started to bleed from little to mass.
The origin of blood flowing in the placenta is the mother's blood, from venous sinuses (blood pools) in the placenta.




Risk to mother and child
For mom
The risk of placenta praevia is: vaginal bleeding, which can be very severe, causing blood loss and maternal death (in Vietnam the maternal mortality rate is about 1.16%); coagulopathy, which may occur, but is uncommon in placenta praevia, even when the placenta is wide-spread.
It can be surmised that Thromboplastin - the factor that promotes intravascular coagulation - in the placenta striker has been released from the cervical canal rather than into the mother's circulation.
For children
Pregnancy is prone to impairment due to anemia; sine.

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