Blood clots and pressure marks on the maternal surface of the placenta

Introduction Placental abruption sometimes has no obvious symptoms and signs. Only when the placenta is examined after delivery, the placenta has clots and indentation on the maternal surface, and the placental abruption is found.

Cause

After decades of research by scientists, early placental dissection and hypertension (including pregnancy-induced hypertension syndrome, essential hypertension, renal hypertension), trauma, premature rupture of membranes, age of pregnant women, smoking, use of cocaine, etc. Factor related.

an examination

Related inspection

Simple thrombin generation test fetal heart monitoring

Diagnose based on

(1) may have a history of trauma, history of vascular disease.

(2) There is vaginal bleeding accompanied by abdominal pain.

(3) The uterus has limited tenderness and tenderness, and it is in a hypertonic state, and the fundus is elevated.

(4) The fetal heart is weakened or even disappeared.

(5) Ultrasound examination showed a dark area between the uterine wall and the placenta. The echo in the amniotic fluid increased and the villus board protruded into the amniotic cavity.

(6) Blood protein is reduced, and coagulation dysfunction may occur.

(7) postpartum examination of the placenta can be seen on the maternal surface of the placenta with clots and pressure marks.

Differential diagnosis

1, placenta previa: light placenta premature detachment, can also be painless vaginal bleeding, signs are not obvious, B-mode ultrasound to determine the lower edge of the placenta, you can confirm the diagnosis. Placental abruption on the posterior wall of the uterus, abdominal signs are not obvious, it is not easy to distinguish from the placenta previa, B-ultrasound can also be identified. The clinical manifestations of severe placental abruption are very typical and it is not difficult to distinguish from placenta previa.

2, aura uterus rupture: often occurs in the process of childbirth, the emergence of strong contractions, lower abdominal pain refused to press, irritability, a small amount of vaginal bleeding, fetal distress signs. The above clinical manifestations are more difficult to distinguish from severe placental abruption. However, there are many uterine ruptures in the aura, uterine tube obstruction or cesarean section history, examination can be found in the uterus pathological retraction ring, catheterization has gross hematuria, etc., and placental abruption is often a patient with severe pregnancy-induced hypertension, check the uterus The plate is hard.

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