Pathophysiology

Predisposing Factors: Avance Maternal Age (>35 years old) Increased Parity Past cesarean births Past uterine Curettage Multiple Gestations Bears a male fetus Asian or African Ethnicity Defective Vascularization of the deciduas Previous Placenta Previa Miscarriage Or Induced Abortiion

Precipitating Factors: Smoking (second hand) Residence at High Altitude Closely space pregnancy Tobacco use or cocaine

UNKNOWN

Pre-embryonic stage Blastocyst is implanted in the endometrial lining of the lower uterine segment (implantation is low) Blastocyst is implanted in the endometrial lining of the lower uterine segment (implantation is low) Maladaptive anatomical development of uterus

Placenta stays at lower part of uterus

Thinning of the lower uterus segment

The growing placenta tends to spread out occluding completely the cervix which is seen through the utz

A
Intrauterine segment contracts and dilates Placenta villi are torn from the uterine wall Blood vessels are torn and exposed Painless vaginal bleeding

Maternal complications Scanty to profuse bleeding

Fetal complication Deprivation of blood and nutrients uteroplacenta insufficinecy

Decreased blood volume

Increased incidence of congenital anomalies

Intrauterin e growth retardation

Fetal hypoxia

Fetal Distress

Hypotension

Decreased red blood cells

Heart compensate by increasing rate and rhythm of contraction Tachycardia

Decreased blood flow to the kidney Decreased urineurine output

Hypovolemic shock

Decreased perfusion to body organs Multiple organ failure

Heart has to work harder to pump blood with more oxygen throughout the body

Anemia Decreased Oxygen Carrying Capacity of blood Lungs Compensate to increase Oxygen in blood B

DEATH

Fatigue Dizziness Headache Coldness in hands and feet Pale skin Chest pain Weakness

B Increased respiratory rate Tachypnea