Conditions placenta previa is the placenta attached to the bottom so as to cover the birth canal, and lead to bleeding during the formation of the lower segment of the uterus, a condition in which a fertilized egg becomes implanted in the lower part of the uterus, which means that the placenta is passed through the uterus and can no longer separate or attached during childbirth or maternity and can cause brain damage in infants. Pregnancy by the placenta attached to the lower part of the uterus, is not at the top; can cause bleeding during pregnancy; and required a caesarean section.
Placenta previa involves the attachment of the placenta over the cervix inside. Various variants of the disease include:
1. The attachment of the placenta completely over the cervix.
2. Most of the edge of the placenta covers the cervix.
3. placenta reaches the border of the uterus.
4. placenta lies low attached and a half to a third of the uterus, or about 2-3 cm and cervix.
Causes of placenta previa
1. Bleeding continuously. It is associated with attachment disorders placenta and cervix and lower uterine segment. The lower part of the uterus is unable to contract and so can not suppress or narrowing of blood vessels in the corpus of the uterus and cause bleeding constantly.
2. At the time of pregnancy, maternal age over 35 years.
3. Childbearing life more than once.
4. Treatment of infertility (infertile).
5. Pregnancy repeated more than once, 6. Disorders perkembanganjanin; the condition of the fetus is impaired by blood Rh factor incompatibility.
7. History of previous uterine surgery or surgery that causes back injury.
8. Recurrent miscarriage. In the event of a miscarriage occurs decay undue fetus. Repeated occurrences could damage the uterus and cause bleeding constantly, despite not having a miscarriage.
9. The socio-economic status are low so there was never a medical examination and there is no adequate basic knowledge about health.
10. The distance between pregnancies is short. Pregnancy is often the short distance will make the uterus constantly working hard to withstand loads. No opportunity to rest and recover, making it vulnerable to bleeding.
11. Smoking. Nicotine contained in cigarettes will disrupt the whole performance sound system, including disorders of the uterus.
12. The use of cocaine. Similar to the use of nicotine in cigarettes, these substances are more dangerous and addictive heavier than cigarettes.
13. Other causes, such as chronic high blood pressure disease, post operative trauma, and a variety of other types of trauma.
Supporting Factor Placenta previa
1. Widening the growth of the placenta outside the normal.
a twin pregnancy. The more babies, the width of placenta
b growth and development of the placenta is very thin and not according to standards
2. Less proliferation of the inner lining of the womb.
a. Nutrition of pregnant women who are not awake nutrition.
b. The widening of the placenta as a twin pregnancy.
c. Often found in women who often give birth, five times or more.
3. Late fetal attachment.
a. The base of the uterine lining less fertile.
b. Delayed growth and development of the products of conception in the form of early developing embryo and morula, consisting of a sphere of cells with a cavity in the middle, called: blastosphere ready for attachment of the embryo in the uterine mucosa.
Process of attachment of the placenta caused by the embryo attaches to the uterine bottom. With the growth and the addition of the placenta, placental development can cover the mouth of the placenta. At this time the placenta shrinkage that may continue as phase previa.
As an important cause of bleeding in the third trimester, placenta previa give you an idea as bleeding without pain. Bleeding is believed to have a relationship with the development of the lower uterine segment in the third trimester. ari-ari tenganggu because of the lower uterine segment thins gradually in preparation for the beginning of birth.
At the time of preparation of events beginning this birth took place, the bleeding occurs in the area of attachment because the uterus can not contract strongly enough. And due to these events will stop the flow of blood and blood vessels open. Thrombin, the enzyme protease in blood that facilitates blood clotting by converting fibrinogen into fibrin which is released and stimulate uterine contractions bleeding area. This causes bleeding repeated, with an iterative process, which is bleeding-contraction-separation of the placenta-bleeding.
Placenta previa Genesis Figures 0.3-0.5% of all births. There is an increased risk of 1.5 to 5-fold when accompanied by a history of cesarean section. With an increase in the number of births by cesarean, this risk can be 10%. Recent research suggests that previous cesarean birth does not increase the amount of placenta previa detected by ultrasonography in the second trimester.
From the observation of the placenta at 28-36 weeks of embryonic development, most cases of placenta previa occurs in women who gave birth naturally. From all of placenta previa, placenta previa frequency total of 20-45%, placenta previa most about 30%, and placenta previa is limited to 25-50%.
Factors that influence susceptibility to Death or Hospital:
1. Bleeding before delivery.
2. The need for surgery.
3. Blood transfusion.
4. Blood poisoning caused by pathogenic micro-organisms and their toxic products in the bloodstream.
5. The process of inflammation of a vein with formation of blood clots in the veins at the site of inflammation.
This process is also known as Flama: thrombophlebitis, phlebitis, phlebothrombosis, and venous thrombosis.
The average mortality in the period around childbirth, especially the five months before until one month after childbirth associated with placenta previa of 2-3%. Maternal mortality rate of 0.03% in the United States.
Placenta previa has no predilection for a specific race. This means that all races can be affected by this disease. Placenta previa occurs only in pregnant women. The risk of placenta previa is related to age at the time pregnant women as follows:
1. Pregnancy at the age of 12-19 years of as much as 1%.
2. Pregnancy at the age of 20-29 years as much as 0.33%.
3. Pregnancy at the age of 30-39 years by 1%.
4. Pregnancy over 40 years as much as 2%.
Clinical symptoms of placenta previa
1. Bleeding without pain, which occurs in the third trimester of pregnancy.
2. It often happens at night when the formation of the lower uterine segment.
3. The lowest part was still high above the pelvic (aberration).
4. Bleeding can be a little or a lot causing symptoms.
Disease history
1. The classic image of placenta previa is vaginal bleeding without pain or tenderness.
2. About two-thirds of patients show symptoms before 36 weeks of gestation, with half and these patients show symptoms before 30 weeks of gestation.
3. The bleeding often stops spontaneously and then again with the pregnancy.
Physical examination of placenta previa
1. All pregnant women beyond the first trimester vaginal bleeding require speculum examination (medical instrument to examine the inner genitals) followed by ultrasound, if there is no previous history of placenta previa confirmation.
2. Bleeding endanger the life, it is absolutely necessary examinations to prove there is a placenta previa.
3. Examination of uterine activity reveals that approximately 20% of patients had a contraction simultaneously with bleeding.
Placenta previa Diagnosis Banding Some circumstances may resemble placenta previa, for example:
1. Separation of preterm or premature release of the placenta.
2. Inflammation of the cervix.
3. The more premature rupture of membranes.
4. Labor may occur early, well before the fetus reaches a weight of 2000 to 2500 grams and before 37-38 weeks and pregnancy; also called premature labor.
5. Inflammation of the vagina.
6. Inflammation of the vulva and vagina.
Laboratory examination
1. Although the events of rare blood clotting disorder, a complete blood count and platelet can be beneficial.
2. Examination of the profiles disseminated intravascular coagulopathy (DIC) and prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and fibrin split products can also help.
Modern examination
1. Examination of the most useful and least expensive is to use a vaginal ultrasound achieve 100% accuracy in identifying placenta previa.
2. As an alternative can be used ultrasound abdominal accuracy reaches 95%; however, the possibility of right or wrong can range from 2% to 25%.
3. MRI (magnetic resonance imaging) may be used to identify pregnancies are accompanied by all the things that are not normal to the placenta. MRI can be used to get optimum and accurate diagnosis.
Other examinations
1. Evaluation of fetal ultrasonography is useful to identify the age and weight of the past development of the embryo, abnormalities that have the potential to decline, abnormal location of the fetus, and evidence of fetal growth restriction. Evaluation of ultrasound is also recommended to identify abnormalities in the tau center.
2. Examination with sterile speculum should be done to evaluate the occurrence of abnormalities in the fetus.
Handling No specific medications and beneficial for patients with placenta previa. Giving tocolysis or inhibitors of uterine contractions
Can be considered carefully in certain circumstances. Encourage, besarkanlah heart, and give encouragement to patients with placenta previa to maintain the intake of iron and folic acid as a safety measure, especially when bleeding occurs.
Tocolytics (cause tocolysis, the agent holding the contraction of the uterus during childbirth can also be given in cases of bleeding is minimal and birth very early to give readiness before giving birth. If there is more than one episode of bleeding during development and normal growth or more than 24 weeks), then the doctor should advise the patient to spend the night in the hospital until delivery. Given this high potential occurrence of fetal death.
Tocolytic is a nutritional supplement in the treatment of placenta previa. The doctor will stop treatment if side effects occur. Repetition of the dose depends on the condition of the patient and the breathing function enough. Useful to prevent contractions that are not on time. For example: magnesium sulfate.
Surgery, this surgical technique should only be performed by a physician in accordance with his expertise.
General management of the placenta previa as follows:
A. Depends on:
1. The general state of the patient.
2. The amount of bleeding.
3. Keadaanjanin in the womb.
B. Prevention:
1. Install a drip.
2. Prepare a blood transfusion.
3. Preparing a reference when at the health center.
C. Diagnosis must have:
1. ultrasonography.
2. Checking in on the operating table.
D. When found in health centers, should be referred to the general hospital type C, better equipment and medical expertise.
E. incidence of placenta previa dwindle:
Along with the growing acceptance of the concept of the safety and health of the mother and her baby.
Prediction of Disease
1. 50% of women with placenta previa have pregnancy-prone.
2. These cases are complicated with vaginal bleeding and very early birth can increase the risk of death before birth.
3. The fetus is not in place and barriers to growth should be wary in case of placenta previa.
Complications Some complications can accompany placenta previa include:
1. Bleeding, which occur due to weak capacity in the lower uterine segment contraction. Delivery planning and control of bleeding is essential to placenta previa.
2. Pregnancy prone or not the time, before 37 weeks),
3. Congenital defects.
4. Location of the fetus is abnormal.
5. The loss of some or all of placental tissue that attaches above normal at 22 weeks of pregnancy and before a child is born or the placenta detached from the attachment in the uterus before the baby is born.
6. There is an unusual blood vessel that precedes the fetal head during childbirth.
7. A torn uterus or vagina.
8. The side wall of the vaginal tear.
9. Abortion or miscarriage.
Prevention There is no cure or specific measures to prevent the occurrence of placenta previa. If placenta previa, do the following:
1. Always check the condition of the womb routinely and regularly.
2. Rest, live regularly.
3. Know what steps should be done in case of contraction or bleeding.
4. Do not work too hard (over-exert yourself).
5. Consumption of food as appropriate. Consult with your doctor what should be consumed during pregnancy.
6. Not a lot of thought and should not be stressful.
7. Living a healthy lifestyle.
8. Do not forget to pray.
Need We Know is the perinatal period (perinatal period), namely:
1. The time before and after the birth (and the 28th week after conception until the first week after birth).
2. Occurs during the period of birth (five months before and one month after).
Many medical terms to declare abortion, among others, miscarriage, abortion, termination of pregnancy, stillbirth, spontaneous abortion, a natural loss of the products of conception.
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