Premature placenta detachment

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Classification according to ICD-10
O45 Premature placenta detachment (abruptio placentae)
ICD-10 online (WHO version 2019)

In the premature detachment of the placenta itself has placenta before birth of the child from the uterus adhesion surface solved. Maternal perfusion of the mother cake is no longer guaranteed. This detachment can take place in part or in full.

reasons

A solution may result from the formation of a hematoma behind the placenta. This hematoma can by various factors, such as trauma , hypertension , premature rupture of the membranes of the mother are triggered, uterine abnormalities, short umbilical cord, but also malnutrition or nicotine and drug abuse. Furthermore, the risk of rupture of the placenta increases with every child.

clinic

In addition to dark red, vaginal spotting (→ peripartum hemorrhage ) of varying strength, there is severe continuous pain with permanent hardness of the uterus. Furthermore restlessness, weakness, feelings of fear and thirst and nausea occur. Signs of acute oxygen deficiency can be found in the child's heart sound recording ( CTG ). In the case of severe maternal blood loss, the mother also shows signs of shock with the occurrence of coagulation disorders.

Diagnosis

In addition to the ultrasound with Doppler sonography , the coagulation diagnosis is of particular importance, since the activation of the coagulation cascade leads to an increased consumption of platelets and coagulation factors.

The mortality of the mother is around 1%; that of the child, depending on their weight, between 10% and 67%.

therapy

If the child is alive, an immediate caesarean section is indicated. If the child has died and the mother has no symptoms, vaginal delivery is sought. If the mother is impaired, the caesarean section is also performed on a dead child. If a state of shock occurs due to bleeding, blood products should be given. Here too, a coagulation disorder should be observed.

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