Placenta presentation (plasenta praevia) - abnormal attachment of the placenta, in which it is located in the region of the lower segment of the uterus, partially or completely below the presenting part of the fetus. It is observed in 0.2-0.9% of pregnant women. With partial placenta previa, the placenta covers only part of the internal uterine throat, next to it, fetal membranes. With complete placenta previa, which occurs less frequently, the placenta completely overlaps the internal uterine zoe. Occasionally the placenta develops in the area of ??the uterine neck and cervical canal - the cervical placenta, according to the Internet edition for girls and women aged 14-35 who have been diagnosed with Pannochka. net Placenta prevalence most often occurs in rebranded and repetitious. abortion, post-abortion and postpartum septic diseases. Based on this, it is believed that the main cause of abnormal attachment of the placenta is the dystrophic changes in the mucous membrane of the uterus. Preposition of the placenta may also be due to malformation of the uterus, the presence of submucous uterine fibroids or scar after a surgery on the uterus. The occurrence of placenta previa in primitive women is associated with sexual infantilism, stagnant phenomena in the small pelvis in diseases of the heart, liver, kidneys.

Due to the peculiarities of the structure of the muscular and mucous membranes of the lower segment of the uterus, the villi of the placenta penetrate deeper than when it is localized in the body of the uterus. In this regard, there is often a partial tight attachment. and sometimes even the true increment of the placenta. As a result, the lower segment of the uterus turns into a peculiar cavernous tissue, which is poorly contracted and easily traumatized; the process of detachment of the placenta in childbirth is disrupted, leading to uterine bleeding.

The most common uterine bleeding with placenta previa occurs in the second half of pregnancy. which is associated with premature detachment of the present placenta as a result of the distraction of muscle fibers in the region of the lower segment of the uterus with its contractions. Bleeding may stop due to vascular thrombosis and cessation of placental abruption. Characterized by repeated uterine bleeding The time of bleeding and its nature correspond to a certain extent with the presentation of the placenta, the earlier during pregnancy there are spotting from the uterus and the more stubborn they are, the more data for complete placenta previa. Bleeding occurs for no apparent reason, often at night, pain is absent. The intensity of bleeding can be different - from scanty smearing discharge to profuse bleeding.

In women with placenta previa, pelvic presentations, oblique and transverse fetal positions are often observed, births often begin prematurely. Uterine bleeding occurs already in the first stage of labor (as a rule, with the onset of labor).

With partial presentation of the placenta, bleeding may stop after the discharge of amniotic fluid and pressing the fetal head to the entrance to the small pelvis. With complete placenta previa, bleeding increases as the cervix opens and can take a life threatening to life. In the third stage of labor, there is a possibility of uterine bleeding associated with impaired abruption of the placenta, rupture of the cervix. In the postpartum period, complications often occur due to posthemorrhagic anemia and surgical interventions that create the risk of septic postpartum diseases.

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