How long can premature rupture of membranes be maintained?

Placental abruption is a very emergency situation for both adults and babies. The hospital may ask relatives to decide whether to save the child or the adult. Placental abruption should be taken seriously. How long can placental abruption keep the fetus safe? Let's find out with the editor below!

How long can placental abruption last?

First of all, for placental abruption after 34 weeks of pregnancy, it is not recommended to maintain the pregnancy. It is recommended to induce labor immediately, terminate the pregnancy quickly, and deliver the fetus as soon as possible to reduce the risk of intrauterine infection. Because the fetus is born after 34 weeks of pregnancy, it can basically survive healthily. Secondly, for placental abruption before 26 to 28 weeks of pregnancy, it is not recommended to maintain the pregnancy. Induction of labor and abandonment of the fetus are recommended, because maintaining the pregnancy will increase the risk of infection and will not help the prognosis of the fetus. Prenatal care is only recommended for placental abruption after 26-28 weeks of pregnancy and before 34 weeks of pregnancy. During the period of pregnancy, antibiotics are given to prevent infection, dexamethasone is given to promote fetal lung development, and uterine contraction retarder is given to inhibit uterine contraction. Generally, the fetus can be kept safe for a few weeks. Of course, it is best to increase the gestational age to after 34 weeks of pregnancy, so that the baby is safe.

Placental abruption occurs after 36 weeks of pregnancy. Because the fetus is already mature, in order to prevent infection, the pregnancy should be terminated as soon as possible under normal circumstances. If labor does not occur within 12 to 24 hours after rupture of membranes, induced labor should be given. Since the neonatal mortality rate shows a clear downward trend with the increase of pregnancy weeks, when placental abruption occurs between 28 and 35 weeks of pregnancy, it is generally recommended to adopt a hopeful treatment method to increase the gestational age and promote fetal lung perfection. Once the fetal lungs are mature, the pregnancy should be terminated as soon as possible. If placental abruption occurs before 28 weeks, because the gestational age is too small and the level of childcare education in most medical institutions in my country is low, the fetal survival rate is still very low, and it is easy to cause unresolved complications. From the perspective of eugenics, the pregnancy should be terminated and conservative treatment is not appropriate.

Causes of placental abruption

1. Hypoplasia of fetal membranes: In addition to the factors of the fetal membranes themselves, factors such as vitamin C deficiency, copper deficiency and smoking in pregnant women in the early stages of pregnancy can cause hypoplasia of fetal membranes. Malnutrition of pregnant women, lack of vitamin C, D and hydroxyethyl sugar (component of the interstitial structure of amniotic membrane) can increase the elasticity of fetal membrane and easily cause placental abruption. Lack of nutrients such as copper and zinc can cause the fetal membrane to become brittle and lack elasticity, which can easily lead to placental abruption.

2. Insufficient cervix: In the case of non-pregnancy, the internal os of the cervix can dilate to 8.0 without frictional resistance, which can confirm the insufficiency of cervix. The specific manifestations of insufficiency of cervix are relaxation of the internal os and defects of the muscle wall.

3. Abnormal uterine cavity pressure: Uneven uterine cavity pressure is often seen in cephalopelvic disproportion and abnormal fetal position; excessive uterine cavity pressure is often seen in twin pregnancy, polyhydramnios, constant coughing and difficulty defecation.

4. Trauma and reflex irritation: mainly divided into iatrogenic and non-iatrogenic categories. Non-medical causes are generally sexual activity in the late stages of pregnancy; medical causes include multiple amniocentesis, multiple vaginal examinations, and membrane stripping surgeries.

5. Inflammation of the reproductive system: Vaginitis and cervicitis can easily cause infection of the fetal membrane and cause rupture of amniotic fluid. The pathogens that cause fetal membrane infection are more complicated, including bacteria, chlamydia and mycoplasma. In particular, chlamydia and mycoplasma infections often have no obvious symptoms and are not easy to be detected by normal mothers.

6. Transverse position of the fetus: pregnant women with multiple births or polyhydramnios are prone to placental abruption due to excessive pressure in the amniotic cavity. Pregnant women with breech presentation, transverse presentation, and cephalopelvic disproportion may suffer from placental abruption due to uneven pressure in the amniotic cavity.

7. Other factors: constant coughing, constipation, and lifting heavy objects can cause a sharp increase in the pregnant mother's abdominal pressure and easily lead to placental abruption.