There is something called abruption of the placenta which means the placenta starts separating before you go into labour which is a serious problem. The placenta is separating from the uterus so it is carrying a lot of blood to the baby. That blood starts collecting behind the placenta. Between the uterus and the placenta, that is an emergency and in most cases, the doctors have to deliver the baby as soon as possible to save the baby's life. So, if the placental formation is not very good, then the baby growth starts getting affected in the second half of the pregnancy, because that's the time when we see the baby increase weight. It's clear that if the baby is not getting enough nutrition from the placenta, then the growth starts getting altered. Then the blood flow is checked from the placenta to the baby in the third trimester. Onlymyhealth editorial team spoke to Dr. Astha Dayal, Consultant, Obstetrics & Gynaecology, Meddo Clinic, about
Causes of placental abruption
As per Dr. Astha, "Placenta is where the ladies will get all their nutritions from. The placental formation starts in the 12th week only. In the first trimester, we get to know how well the placenta is formed by doing some tests. So, that gives us an idea on how good the placental formation is. Some factors are in your control whereas some aren't." They are:
1. If the woman who is pregnant at 40 years of age, then her placental formation may not be that good.
2. If somebody smokes, or are into occasional drugs like cocaine, that can affect the placenta.
3. If somebody has high risk pregnancy like a twin or a multiple pregnancy or has high blood pressure in pregnancy can also become a reason for placental abruption
4. It's also a risk if the person has had surgeries on the uterus
5. Another cause is when there's a fibroid and the placenta is formed over the fibroid. Then, it may not be very well formed.
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So, all these things can disturb the placenta but these start happening in the first trimester. Sometimes, it happens that the placenta stays low and it is called placenta previa. Most of these things are not in your control. You can't control the position of the placenta and if it stays low as the pregnancy goes ahead then it can cause the occasional bleeding off and on. It can cause chances of a C-section or a preterm delivery so that is why it is called a low lying placenta.
Symptoms of Placental abruption
In the first trimester, the placental tissue is all around the baby and towards the end of the first trimester, the placenta starts shrinking and localising at a particular area. So, if you get bleeding in the first trimester, it is not generally from the placenta, it is from the fats surrounding the baby. The placenta actually forms by the end of the first trimester. If it's placenta previa, then there's bleeding and that is the symptom. It's a painless, causeless bleeding. It can happen at any time. You might even feel pain and bleeding in some cases. Bleeding happens in 80% cases, but in 20% there might not be bleeding and there is pain. If you're not having contractions, but you feel a little pain and hardness on the uterus. In most cases, it acts naturally and if the patient starts having abruption, then the patient goes into labour automatically. The pain starts quite slowly.
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Placenta abruption treatment
Dr. Astha said, "If it is very early like before 34 weeks and there's a small abruption like the clot is very small behind the placenta and it resolves on its own then we continue with the pregnancy because the baby is very small so we want the baby's lungs to be matured. Medicines are given so that the baby develops faster and then taken for delivery. This is called a mild abruption, where it's a small clot and the baby has tolerated that. The baby is fine and the blood clot wherever it was has stopped forming and is not increasing. So, this is a rare scenario that the clot stopped there itself and then it continues.
In most cases, the abruption happens after 34 weeks which is after the 8th month then generally, to save the baby, surgeons deliver the baby. If she's already in labour, then deliver normally. If she is having pains due to the abruption and has gone into labour, it can be delivered normally. But, if it's in very early stages of labour, the pain hasn't started and the blood is getting collected inside, then the only way to save the baby is to deliver by a C Section, and also to save the mother in that case. So, it's best to deliver the baby for both the mother and the baby.
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