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The following have been identified as risk factors for placenta previa: Previous placenta previa (recurrence rate 4–8%), [13] caesarean delivery, [14] myomectomy [10] or endometrium damage caused by D&C. [13] Women who are younger than 20 are at higher risk and women older than 35 are at increasing risk as they get older.
Eclampsia may also cause problems with the placenta. The placenta may bleed ( hemorrhage ) or begin to separate early from the wall of the uterus. [ 28 ] It is normal for the placenta to separate from the uterine wall during delivery, but it is abnormal for it to separate prior to delivery; this condition is called placental abruption and can ...
These factors are known to be the primary pathophysiology cause placental disease. Which is considered to be associated with more than half of premature births. [4] Abnormalities present within the spiral arteries lead to higher velocities in blood, in turn causes the maternal villi to shred. [5]
Placenta previa is a condition that occurs when the placenta fully or partially covers the cervix. [13] Placenta previa can be further categorized into complete previa, partial previa, marginal previa, and low-lying placenta, depending on the degree to which the placenta covers the internal cervical os.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Risk factors include pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached. [1] Other risk factors include uterine atony, placenta previa, and connective tissue disorders. [1] Diagnosis is by seeing the inside of the uterus either in or coming out of the vagina. [2] [6]
Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation.
Patients can have pain secondary to uterine contractions, uterine tetany or localized uterine tenderness. Signs can also be due to abruptio placentae including uterine hypertonus, fetal distress, fetal death, and rarely, hypovolemic shock (shock secondary to severe blood loss). The uterus may adopt a bluish/purplish, mottled appearance due to ...