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Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts": [12] Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony.
Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall. [2] It occurs in about 3.1% of all pregnancies , [ 2 ] it is the most common sonographic abnormality and the most common cause of first trimester bleeding .
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Large placental infarcts are associated with vascular abnormalities, e.g. hypertrophic decidual vasculopathy, as seen in hypertension. [1] Very large infarcts lead to placental insufficiency and may result in fetal death. Placental infarcts are generally detected after birth, although using ultrasound may be a way to notice infarcts prenatally.
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]
Normally the maternal circulation and the fetal circulation are kept from direct contact with each other, with gas and nutrient exchange taking place across a membrane in the placenta made of two layers, the syncytiotrophoblast and the cytotrophoblast. Fetal-maternal haemorrhage occurs when this membrane ceases to function as a barrier and ...
Funic souffle (also known as funicular or fetal souffle), is a blowing sound heard in synch with fetal heart sounds, and may originate from the umbilical cord. It has also been described as a sharp, whistling sound that is synchronous with the pulse of the foetus, usually heard during the second trimester of pregnancy (13–28 weeks). [3]
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]