Placenta disorder

Overview

Placenta disorder (medical condition): Any condition affecting the placenta. The placenta is an organ that connects the fetus to the mother's uterus and provides the baby with nourishment and removes waste.

Symptoms

Fetal death Poor fetal growth Premature birth Stillbirth Abnormal bleeding during pregnancy

Causes

The cause of abruptio placentae is often unknown. Predisposing factors include trauma, such as a direct blow to the uterus, placental site bleeding from a needle puncture during amniocentesis, chronic or pregnancy-induced hypertension (which raises pressure on the placenta’s maternal side), multiparity, smoking, and cocaine abuse. In abruptio placentae, blood vessels at the placental bed rupture spontaneously owing to a lack of resiliency or to abnormal changes in uterine vasculature. Hypertension complicates the situation, as does an enlarged uterus, which can’t contract sufficiently to seal off the torn vessels. Consequently, bleeding continues unchecked, possibly shearing off the placenta partially or completely. Typically, such bleeding is external or marginal (in about 80% of patients) if a peripheral portion of the placenta separates from the uterine wall; it is internal or concealed (in about 20%) if the central portion of the placenta becomes detached and the still-intact peripheral portions trap the blood. As blood enters the muscle fibers, complete relaxation of the uterus becomes impossible, increasing uterine tone and irritability. If bleeding into the muscle fibers is profuse, the uterus turns blue or purple, and the accumulated blood prevents its normal contractions after delivery (Couvelaire uterus, or uteroplacental apoplexy).

Diagnosis

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