Symptoms of placental abruption in late pregnancy

Regarding the duration of pregnancy, a common saying is that it takes ten months. From this we can see that the baby has to stay in the mother's belly for ten months before it is considered mature. But in fact, not all children are born at a full moon. Due to special circumstances, such as physical problems of the pregnant woman or influence of the external environment, the child may be born prematurely. What are the symptoms of placental abruption in late pregnancy?

After 20 weeks of pregnancy or during delivery, the normally located placenta partially or completely separates from the uterine wall before the fetus is delivered, which is called placental abruption. The main symptom of mild placental abruption is vaginal bleeding, which is usually heavy and dark red in color. It may be accompanied by mild abdominal pain or no obvious abdominal pain, and no obvious signs of anemia. The main symptoms of severe placental abruption are sudden and persistent abdominal pain and/or low back pain. The severity of the pain varies depending on the size of the separation surface and the amount of blood accumulated behind the placenta. The more blood accumulated, the more severe the pain.

Clinical manifestations

1. Mild placental abruption

The main symptom is external bleeding, and the placental detachment surface usually does not exceed 1/3 of the placenta, which is more common during delivery. The main symptom is vaginal bleeding, which is usually heavy and dark red in color, and may be accompanied by mild abdominal pain or no obvious abdominal pain, and no obvious signs of anemia. If it occurs during labor, labor will progress faster. Abdominal examination: The uterus is soft, uterine contractions are intermittent, the size of the uterus is consistent with the gestational age, the fetal position is clear, the fetal heart rate is mostly normal, if the amount of bleeding is large, the fetal heart rate may change, tenderness is not obvious or only mild local tenderness (placental abruption). Postpartum examination of the placenta revealed blood clots and pressure marks on the maternal surface of the placenta. Sometimes the symptoms and signs are not obvious, and placental abruption is only discovered when the placenta is examined after delivery and blood clots and pressure marks are found on the maternal surface of the placenta.

2. Severe placental abruption

The main symptom is internal bleeding, with the placental detachment surface exceeding 1/3 of the placenta and a large retroplacental hematoma, which is more common in severe gestational hypertension. The main symptoms are sudden and persistent abdominal pain and/or back pain. The severity of the pain varies depending on the size of the separation surface and the amount of blood accumulated behind the placenta. The more blood accumulated, the more severe the pain. In severe cases, nausea, vomiting, and even signs of shock such as pale complexion, sweating, weak pulse and low blood pressure may occur. There may be no vaginal bleeding or only a small amount of vaginal bleeding, and the degree of anemia is inconsistent with the amount of external bleeding. Abdominal examination: The uterus is hard and board-like on palpation, with tenderness, especially at the site of placental attachment. If the placenta is attached to the posterior wall of the uterus, uterine tenderness is often not obvious. The uterus is larger than the gestational age, and as the retroplacental hematoma continues to grow, the uterine fundus rises and the tenderness becomes more obvious.