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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.
In the early stages of placental abruption, there may be no symptoms. [1] When symptoms develop, they tend to develop suddenly. Common symptoms include: sudden-onset abdominal pain [5] [8] contractions that seem continuous and do not stop [5] vaginal bleeding [5] [8] enlarged uterus (disproportionate to the gestational age of the fetus) [5]
Especially when these symptoms are evident at early stages of pregnancy. [3] The abnormal invasion of the trophoblast cells, lack of important growth factors such as vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), has an association with the onset of placental disease.
Sheehan noted that significant feature of these patients' cases was hemorrhaging, which in his experience was most commonly caused by either: placenta Previa (low placenta), uterine rupture, cervical or uterine tears, post-partum atony, or retained placenta. Simmonds' disease, however, occurs in either sex due to causes unrelated to pregnancy. [15]
Placenta praevia refers to when the placenta of a growing foetus is attached abnormally low within the uterus. Intermittent antepartum haemorrhaging occurs in 72% of women living with placenta praevia. [6] The severity of a patient's placenta praevia depends on the location of placental attachment;
Symptoms: Postpartum bleeding, abdominal pain, mass in the vagina, low blood pressure [1] Types: First, second, third, fourth degree [1] Risk factors: Pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached, uterine atony, placenta previa, connective tissue disorders [1] Diagnostic method
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]
Obstetrical hemorrhage may be due to a number of factors such as placenta previa, uterine rupture or tears, uterine atony, retained placenta or placental fragments, or bleeding disorders. [71] Puerperal sepsis is an ascending infection of the genital tract. [72] It may happen during or after labour.