Diagnosis of premature placental detachment
A rapid diagnosis of premature placental detachment is vital, especially in severe cases. For this reason, continuous monitoring of vital parameters and, via CTG (cardiotocography), imaging of the child’s heartbeat are necessary. A palpation of the abdomen and uterus serves to assess the height of the uterus and its tone.
The ultrasound can be used to check the position of the placenta and also show the activity of the child via its movements. It is also possible to detect possible bruising and the trigger of a premature placental detachment. In addition, a blood sample is taken in order to assess in particular the coagulation parameters, which can increase sharply in the event of a premature placental detachment.
The hemoglobin value is also determined to estimate the extent of a possible bleeding. Ultrasound is an indispensable diagnostic procedure in cases of suspected premature placental detachment. Ultrasound can be used to determine the location and position of the placenta.
In addition, it is possible to look for a hematoma, i.e. a bruise, between the placenta and the uterus, as this is one of the possible causes of premature placental detachment. The activity of the fetus can also be recorded by imaging its movements using ultrasound. The activity of the child is an important means of assessing the health status of the fetus, in addition to monitoring the child’s heart activity using a CTG device.The ultrasound procedure can also be used to detect placental diseases. A frequent disease is the calcification of the placenta.
Symptoms of premature placental detachment
Premature placental detachment is not always associated with symptoms. In 20-30% of cases, the placenta detachment remains completely free of symptoms and can only be detected with the ultrasound machine. The possible accompanying symptoms correlate with the degree of detachment.
Grade 1 of premature placental detachment is a very minor detachment, which in most cases causes no symptoms at all. If we speak of grade 2, it is a somewhat more severe detachment, which can be accompanied by slight vaginal bleeding. The uterus remains soft in its consistency.
The condition of the fetus is also usually unremarkable. Grade 3 describes a very pronounced placental detachment, which is associated with heavy bleeding and sometimes severe pain on the mother’s side. If the mother suffers massive blood loss, a state of shock may occur.
This bleeding does not always have to come out vaginally, in some cases the blood seeps behind the placenta and is not noticed at first. The uterus is hard and tense during the examination, the contractions can also increase massively and a so-called ‘contraction storm’ can occur. The child’s heart activity is pathologically altered and it suffers from a lack of oxygen.
The intrauterine death of the fetus in the womb can occur. In particularly severe cases, the mother’s coagulation disorders and disseminated intravascular coagulation (DIC) can occur, with an increased tendency to bleed due to the consumption of factors important for the coagulation process. A placental detachment is not always associated with symptoms.
Therefore, the absence of symptoms is no guarantee that the pregnancy will be regular and that the placenta will fit and function properly. In many cases, however, premature placental detachment is manifested by severe pain and increasing pressure sensitivity of the pregnant woman’s abdomen. Often the pain does not build up gradually, but starts very suddenly and with high intensity localized in the lower abdomen.
A quick consultation with a doctor is highly recommended. There need not always be signs of a premature placental detachment as about one third of the cases remain completely symptom-free. Therefore, the pregnant woman should always take advantage of the recommended medical check-ups during pregnancy, where, among other things, the placental seat and its functionality are assessed.
This allows changes to be recorded and acted upon if necessary. If vaginal bleeding suddenly occurs during pregnancy, there are several possible causes, and one must always consider the possibility of premature placental detachment. Therefore, the pregnant patient should always consult a doctor as soon as possible in case of bleeding and unclear pain.
