What is uteroplacental stroke?

Many people are confused when they hear the term uteroplacental stroke. This is mainly due to the lack of knowledge in this area. In order to popularize this knowledge and allow us to better protect the health of pregnant women, we need to understand this knowledge. So what exactly is uteroplacental stroke? To answer this question, we asked an authoritative obstetrician and gynecologist to explain this to us in detail.

1. Uteroplacental apoplexy, also known as Couvelaire uterus, is when internal bleeding occurs due to placental abruption, blood accumulates between the placenta and the uterine wall. As the pressure of the retroplacental hematoma increases, blood infiltrates into the myometrium, causing muscle fiber separation, rupture, and even degeneration. When the blood penetrates into the uterine serosa, the surface of the uterus appears purple-blue bruises, which is called uteroplacental apoplexy. Due to blood infiltration, the contraction force of the myometrium is weakened, causing postpartum hemorrhage. Therefore, the main manifestations of uteroplacental stroke are similar to those of severe placental abruption.

2. Severe placental abruption: The main symptom is internal bleeding. The placental detachment surface exceeds 1/3 of the placenta. At the same time, there is a large retroplacental hematoma, which is more common in severe gestational hypertension. The main symptoms are sudden persistent abdominal pain and (or) low back pain. The degree of low back pain varies with the size of the detachment surface and the amount of retroplacental blood accumulation. The more blood accumulates, the more severe the pain. In severe cases, nausea, vomiting, pale complexion, sweating, weak pulse and decreased blood pressure and other signs of shock may occur. There may be no vaginal bleeding or only a small amount of vaginal bleeding. The degree of anemia is inconsistent with the amount of external bleeding.

3. Abdominal examination: The uterus is hard and board-like and tender, especially at the placenta attachment. If the placenta is attached to the posterior wall of the uterus, the uterine tenderness is not obvious. The uterus is larger than the gestational weeks and as the retroplacental hematoma continues to grow, the uterine fundus rises and the tenderness is more obvious. Occasionally, the uterus is in a state of hypertonicity during contractions and cannot relax well during the intervals, so the fetal position is not clear. If the placental detachment surface exceeds 1/2 or more of the placenta, the fetus often dies due to severe hypoxia. Therefore, the fetal heart rate of severe patients has disappeared.

What is uteroplacental stroke? I believe that through the above introduction, you have already understood the relevant situation of this issue. It is necessary to pay attention to the health care of pregnant women in many aspects in daily life. Only after taking appropriate protective measures in normal times can we protect the health of pregnant women more effectively. If there is something you don’t understand, you can go to a relevant professional doctor and ask them to explain it to you specifically.