Poor placental blood perfusion

Introduction After 5 months of gestation, the uterus is increasing. When the uterus is supine, the uterus compresses the blood vessels in front of the spine, thereby reducing the blood output of the heart and reducing the perfusion of the uterus placenta. If the abdominal aorta is compressed, the uterus placental blood flow is directly reduced. Insufficient long-term placental perfusion, fetal hypoxia, can lead to intrauterine growth retardation, acute and severe placental perfusion can cause fetal distress. Fetal distress is a comprehensive symptom and is one of the main indications for current cesarean section. Fetal distress occurs mainly during the labor process and can also occur in the second trimester. Occurrence in the process of labor, can be the continuation and aggravation of the late pregnancy.

Cause

Patients with antiphospholipid antibody (APA) positive have extensive microthrombus formation in the decidual blood vessels. APA can affect the coagulation system in a variety of ways, leading to hypercoagulable state of the blood, causing microvascular thrombosis in the placenta, placental infarction caused by placental perfusion, and eventually leading to miscarriage.

an examination

Related inspection

Obstetric B ultrasound heart movement

Fetal movement monitoring

It indicates that the fetal movement is reduced, especially when the fetal movement is less than 4 times/hour, it is necessary to pay attention to the possibility of fetal death.

2.B type ultrasound system examination

Fetal biparietal diameter, head and abdomen circumference ratio, femur length, amniotic fluid volume, etc. indicate fetal growth retardation.

3. Fetal heart monitoring has prenatal stress-free test (nst)

When the fetal movement is observed, there is no accelerated reaction, or no fetal movement, which means no reaction. Sometimes the fetal heart rate spontaneously decelerates. The contraction stress test (cst) can be a positive result.

4. Comprehensive biophysical image score check

That is, the B-type ultrasound measurement of fetal respiration, fetal movement, fetal tension, amniotic fluid volume, nst test by fetal monitoring, can be expressed as a low score.

5. Placental function check

The ratio of estriol, placental lactogen, and estrogen/creatinine can be measured, with a continuous low or decreasing trend.

Differential diagnosis

Placental dysfunction: pathological changes in the placenta can reduce the volume of the placenta, reduce the total cross-sectional area of effective blood vessels, increase blood flow resistance, and reduce blood perfusion.

Vascular Doppler ultrasound can help diagnose the arteriovenous thrombosis; B-ultrasound can monitor the placental function and fetal condition in the middle and late pregnancy. Antiphospholipid antibody (APA) is positive.

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