Placental polyp, symptoms, treatment. Placental polyp Placental endometrial polyp with blood flow

Placental polyp is a neoplasm formed from the mucous endometrium and the remnants of placental tissues. Pathological proliferation of mucous membranes rushes into the cavity, has a wide base or a thin stalk (mainly without a stalk). Treatment of the disease is always surgical, with long-term restorative drug treatment. When the first symptoms appear, you should immediately contact a specialist.

A placental polyp after an abortion occurs in only 1.7% of all clinical complications. Predisposing factors are hereditary predisposition to polyps of any localization, as well as the presence of pathological growths in the uterus, cervical canal, lumen of the cervical canal.

There are two main types of medical abortions.:

1. Surgical or instrumental- curettage followed by vacuum aspiration up to 12 weeks of pregnancy and up to 22 weeks for special indications;
2. Medicamentous or "velvet"- miscarriage under the influence of drugs up to 6-8 weeks.

In both cases, a woman should be followed by a gynecologist for several months.

The placenta begins to form immediately after conception, and completes its formation by the 14-15th week of pregnancy. After this period, the process of its aging begins. The later the abortion is done, the greater the risk of attachment of fragments of the placenta along with blood clots to the wall of the uterus and their subsequent formation into polyps.

The main causes of a polyp in medical abortion are:

• Incomplete curettage or discharge of the placenta during a "velvet" abortion;
• Infection:
• Increased accumulation of blood in the uterine cavity;
• Prolonged bleeding (as a result of trauma to the uterus, hormonal disorders);
• Insufficient medical qualifications (including clandestine abortions in underdeveloped or highly religious countries).

It is important! Incomplete abortion or prolonged bleeding is a life-threatening clinical situation that requires urgent hospitalization of a woman and subsequent cleaning of the uterine cavity with an instrumental method.

In the case of a medical abortion, a woman may have a low level of hormonal levels, which cannot provide a normal contraction of the uterine cavity and remove the remnants of the placenta.

Fragments of placental tissue grow into the connective tissue layer of the endometrium, actively grow into the vascular component and form something like an elevation above the inner layer of mucous membranes, which is called a polyp.

Clinical manifestations

The main symptom of pathological growths after abortion is bleeding due to normal physiology.

The placenta that has not separated is tightly fused with the endometrium, which is lined with an abundance of blood vessels, capillaries, which “fall off” or narrow naturally after childbirth. The rest of the placenta secretes specific components that affect the hormonal background, which prevents uterine contraction and narrowing of the vascular lumens.

Features of bleeding in placental polyps are as follows:

• In the first 3-4 days, bleeding is weak, not intense. This is due to the activity of the hormone oxytocin, which spasms the blood vessels for some time after the termination of pregnancy.
• In the next week, bleeding should stop, gradually forming an ichorus. With complications, the intensity of bleeding only increases. The remaining remnants of the placenta can not only adhere to the mucous tissue, but also become inflamed.
• The color of blood is scarlet, bright red. Such bleeding is of a uterine nature, does not mix with vaginal discharge, and carries a certain danger to the life and health of a woman. With their constant nature, measures are required to stop the bleeding.

Against the background of bleeding, iron deficiency anemia often develops. In blood tests, hemoglobin drops sharply, the level of red blood cells.

On a note! The norm of hemoglobin for a healthy woman: 120.0 g / l-140.0 g / l; erythrocytes - 3.9-4.0 x 10.2 / l.

In addition to the main symptoms, they join:

• pallor of the skin,
• malaise,
• weakness,
• dizziness,
• dry mouth
• fainting states.

If symptoms persist, women require hospitalization and prolonged recovery.

With placental polyps after a medical abortion, the following symptoms may also develop:

• Soreness in the lower abdomen of varying intensity;
• atypical vaginal discharge;
• Increase in body temperature;
• Accession of an infection.

The first symptoms of a woman are often felt a month after the abortion, as well as immediately after curettage or drug rejection of the fetal egg. In this case, the bleeding simply does not stop.

Attention! A timely visit to a doctor, and sometimes emergency hospitalization, helps not only to maintain the health of the reproductive system, but also the life of a woman.

Treatment tactics

Treatment of polyps usually involves surgery, but there is a whole range of measures that will help relieve the symptomatic manifestations of placental uterine polyposis.

Despite the nature of the occurrence of the placental polyp, oncogenic risks of its development also remain.

Such a polyp may eventually:

• Transform into carcinoma;
• Get a plural character;
• Cause infertility.

The treatment regimen is selected only after the examination of the patient, which includes ultrasound, hysteroscopy and other necessary measures similar to those for examination.

Non-surgical correction

Drug therapy can be symptomatic or restorative. In the first case, doctors eliminate the consequences of polyps, alleviate the condition of a woman with bleeding, inflammation.

Drug therapy is also prescribed as a preparation for surgical treatment for some complications.

The following drugs are usually prescribed:

• Iron-containing- to eliminate the anemic syndrome according to the patient's clinical history;
• Anti-inflammatory non-hormonal- for pain relief;
• Antispasmodics- to reduce spasms of the muscular muscles of the uterus;
• Antibacterial agents- to prevent or eliminate inflammatory processes;
• Vitamin complexes, minerals, dietary supplements- to strengthen the body.

With intense bleeding, deep tamponade of the uterus and vagina with special preparations may be indicated.

note! There are known cases of self-amputation of the polyp after another pregnancy and independent childbirth.

The doctor may take expectant management if the formed polyp:

1. Does not cause any particular inconvenience;
2. It is not the cause of the aggravation of the morbid condition of the woman;
3. Does not contribute to the development of unpleasant symptoms.

The placental polyp is a benign neoplasm. This type of growth is formed in the uterine cavity after childbirth or medical abortion. Its growth can be provoked by scraping for the purpose of examination or therapy.

Placental formation often occurs as a result of childbirth if the parenchyma has not been completely removed. Its remains are the basis for the future polyp.

Sometimes a placental polyp can begin to grow during pregnancy. In this case, treatment is postponed until delivery. As a rule, education does not interfere with the development of the fetus. The placenta and polyp are shed during childbirth, and further therapy is most often not required.

The main reason for the formation of a placental polyp after childbirth is the incomplete removal of the placenta. The process does not occur in one day.

The chorionic polyp is initially small. This is a piece of the placenta. Blood clots begin to stick to it, the formation sprouts with vessels and connective tissue. When enlarged, it may look like a mushroom or a flat tissue formation.

The following factors lead to the formation of a decidual polyp:

• incomplete separation of the placenta during caesarean section;
• medical or medical abortion;
• incorrectly executed;
• missed pregnancy, after which the fetal egg was not completely removed;
• early miscarriage.

If, after cleaning the uterine cavity, the place of attachment of the embryo was not completely scraped out, after the birth of the child, the entire placenta was not removed naturally or by caesarean section, the risk of placental growth is high. Such neoplasms do not resolve on their own, treatment is required.

Therapy is not needed if the formation grew during childbirth and then went out with the baby.

Main symptoms

The placental outgrowth on the background of a honeybort or the birth of a child may go unnoticed, since pain in the lower abdomen and uterine discharge are considered normal during this period.

An attentive woman will be able to notice that the discharge from the genital tract differs from the norm 7Burl%7D%5C%22%3ETEXT_LINK%3C%2Fa%3E%3Ca+href%3D%5C%22%7Burl%7D%5C%22%3ETEXT_LINK%3C%2Fa%3E%3Ca+href%3D%5C% 22%7Burl%7D%5C%22%3ETEXT_LINKS%3C%2Fa%3Eal. Bleeding may be of a different nature, occur at the wrong time and be longer.

Normally, blood clots after childbirth go immediately, gradually subsiding. With a polyp, this occurs later than the appointed time. Bleeding a woman can observe a few weeks after delivery. The appearance of unusual symptoms should prompt her to see a gynecologist in order to avoid serious consequences.

The following conditions may occur:

• weakness caused by anemia;
• changes in body temperature;
• pale skin;
• loss of consciousness;
• unpleasant pain in the reproductive system.

The symptoms of placental growth differ depending on the phenomenon after which it was formed. It is important to distinguish the state of the norm from the pathology.

After childbirth

The placental polyp after childbirth is associated with the remnants of parts of the placenta in the uterine cavity. Incomplete curettage after the birth of a baby or caesarean section leads to the growth of the neoplasm.

Fragments of this temporary organ are tightly attached to the walls of the endometrium, splicing together. The main symptom of pathology in this case is bleeding.

Since after childbirth, women go for some time with lochia, primiparous mothers may not distinguish them from pathology. Normal spotting after the birth of a child does not become stronger with time, does not change intensity.

After the termination of the lochia do not resume. If this happens, this is a clear symptom of pathology.

If the formation of a placental growth in the uterine cavity is complicated by the addition of an infection, the woman will suffer from elevated body temperature. Help is important to provide as soon as possible, since the penetration of bacteria into the bloodstream leads to sepsis.

During the menstrual cycle

When a placental polyp in the uterus has grown as a result of poor-quality gynecological manipulations or as a complication after a medical abortion, the woman's periods soon resume. If a neoplasm appears, the nature of menstrual bleeding can change significantly.

Allocations during the formation of a polyp differ in duration. Normal menstruation should have ended by now, but the bleeding continues. The condition can cause complications such as:

• inflammation and dysfunction of the ovaries;
• infertility;
• sepsis;
• anemia.

If the pathology is not cured quickly, in the future, even after removal, relapses are possible. Some female diseases lead to the fact that complete removal of the uterus is required to get rid of them. In this case, the reproductive function is forever lost.

Only a placental polyp during pregnancy does not require treatment. The problem disappears on its own after childbirth. The disease does not affect the growth, development of the child and the process of bearing.

During pregnancy

Sometimes a placental polyp in the uterus begins to grow during pregnancy. Examination before conception does not show pathology, but subsequent ultrasounds reveal a violation. Do not worry, because in this case the disease is not dangerous, after the birth of the baby, the condition stabilizes on its own.

A woman can suspect the appearance of a polyp from the placenta by the following symptoms:

• emergence from the uterus;
• pain and spasms;
• fluctuations in body temperature;
• discoloration of the secretion of the uterine mucosa.

Although pathology during pregnancy is not dangerous, it is important to immediately contact a gynecologist and undergo an examination to prevent complications. This will make sure that the child is not in danger, and the gestation is going well.

Diagnosis

Removal of the placental polyp is carried out only after a thorough diagnosis of the woman's health status and determination of the type of neoplasm. Diagnostics includes the following steps:

• collection of anamnesis;
• gynecological examination;
• taking biomaterial for research;

In more rare cases, Dopplerography is also used to diagnose a placental neoplasm. Such studies are necessary if the doctor finds it difficult to make a diagnosis.

Before the examination, the gynecologist will interview the woman, specifying which procedures preceded the onset of negative symptoms. This will help determine the changes that the uterine lining may have undergone.

Examining a woman with the help of gynecological mirrors will allow the doctor to assess the condition of the cervix and cervical canal. In rare cases, the neoplasm protrudes slightly into the vagina.

Ultrasound of the neoplasm allows you to confirm its presence in the uterine cavity. With the help of hysteroscopy, material is taken for histological examination in order to determine the type of tissues and differentiate them from an oncological tumor.

Polyp removal

A polyp after an abortion or the birth of a child is removed from the uterine cavity with the help of surgical intervention. At the moment, this is the most effective technique to prevent the recurrence of the disease.

It is carried out in several ways. They differ in the degree of injury to the tissues of the uterus and the period of rehabilitation. The most commonly used methods are:

• instrumental scraping;
• vacuum aspiration;
• freezing;
• moxibustion.

Classical scraping is used less and less. Although this method can completely remove the chorionic polyp after medical abortion, the method is traumatic. Prolonged bleeding and complications are not excluded.

Increasingly, cryodestruction with liquid nitrogen or cauterization with an electrocoagulator is used. After such interventions, women recover quickly, but it is not always possible to conduct a histological examination of the neoplasm after its removal.

In extremely rare cases, more drastic therapy is undertaken - complete removal of the uterus and appendages. Such treatment is carried out only with a confirmed oncological tumor or with the formation of multiple polyps. This technique is sometimes prescribed to women if placental polyposis recurs repeatedly.

Treatment

Treatment of a placental polyp after a medical abortion or childbirth with the help of medications is carried out after surgery. Such therapy can be an alternative to the complete removal of education only in the following cases:

• the polyp is small and does not interfere with the woman yet;
• the absence of a tendency to malignancy has been proven;
• does not exacerbate the course of other pathologies of the genital area.

Waiting for a doctor does not mean that treatment is not required. During this period, a woman should undergo regular examinations of the uterine cavity in order to control the growth of the polyp.

Competent therapy will reduce the symptoms of polyposis at the stage of preparation for surgery or after it. Doctors often prescribe the use of such drug groups as:

• iron preparations - to prevent anemia due to blood loss;
• antibiotics - with the addition of a bacterial infection;
• non-steroidal anti-inflammatory drugs - for pain relief;
• antispasmodics;
• vitamins.

There are cases when a woman has another pregnancy due to illness. In the process of the next birth, the membranes came out along with the polyp. Placental tissues were removed along with the child, and a cure occurred.

However, such situations are an exception. In most cases, adequate medical therapy and surgery are required.

Prevention

You can prevent the appearance of a placental polyp as a result of a medical abortion or after a miscarriage if you follow simple rules:

• use contraceptives to prevent unwanted conception;
• during pregnancy, regularly visit a gynecologist;
• after childbirth, examine the cervix;
• choose doctors with extensive experience to resolve a uterine pregnancy or caesarean section;
• refrain from any type of abortion.

It is not always possible to influence the actions of doctors and predict their qualifications in advance. However, if after childbirth a woman listens to her own feelings, she will be able to suspect the presence of a pathology at an early stage.

It is necessary to treat a placental neoplasm in order to avoid complications. When the polyp reaches a large size, there is a risk of high blood loss and even death of a woman. Timely diagnosis and treatment will avoid any negative phenomena.

From the uterus after childbirth. Such neoplasms most often progress and lead to serious disorders at the level of the body as a whole. As a result, when placental polyps are detected, it is urgent to carry out a number of therapeutic measures that will restore the impaired functions of the body.

Treatment of placental polyps can be divided into two large areas:
1. surgical removal of neoplasms;
2. medical treatment of symptoms and complications.

Surgical removal of neoplasms.

To remove placental polyps of the uterus, almost any of the following methods will work:

• hysteroscopic removal of polyps;
• laser surgery;
• cryodestruction;
• radio wave method.

Surgical removal of placental polyps may be delayed in the following cases:

• severely weakened body after childbirth;
• development of infectious complications it is advisable to first treat with antibiotics to prevent the spread of infection);
• lactation ( in some cases, due to stress in the postoperative period, a woman may lose breast milk).

Medical treatment of symptoms and complications.

Placental polyps are common among women of childbearing age. There are many causes of polyp manifestations. Compliance with preventive measures and the passage of annual examinations can prevent the development of formations in the uterus.

What it is?

A placental polyp is a complication that can occur after childbirth, abortion, miscarriage, or as a result of a missed pregnancy. In the uterine cavity, the remaining particles of the placenta begin to form. With a placental polyp, intense postpartum or post-abortion bleeding occurs, which leads to anemia and the addition of a secondary infection.

The formation may have a thin stem or a wide base. In terms of symptoms, it may resemble a decidual polyp of the uterus - a benign growth of the endocervix mucosa, which does not require special treatment and does not pose a threat to the woman and the fetus. While the placental polyp is considered a serious pathological disease. It cannot disappear on its own and, as a rule, causes the development of serious complications: infertility, sepsis, anemia.

The reasons

There is a formation due to the growth of remnants of placental tissue in the uterus. The reason for this may be a poorly performed abortion or an unprofessional caesarean section, and pathology may appear after miscarriages or even childbirth.

The most common factors leading to the development of a placental polyp are:

• poorly performed emptying of the uterus, inaccurate curettage;
• non-compliance with recommendations in the postpartum period;
• in the case of a caesarean section, placental tissues may not be completely eliminated;
• with intrauterine fading of the fetus, typical signs may be absent, which leads to adhesion of unformed particles of the placenta to the uterine cavity;
• in early termination of pregnancy.

signs

The underlying symptom of a placental polyp is profuse uterine bleeding. Many women do not attach importance to blood clots, as they consider them normal after the procedures. But here it is important to understand that standard bleeding does not last long and is not plentiful. In the case of the disease, the blood is released from the uterus outside the box, it usually runs without stopping.

Against the background of heavy blood loss, a woman may feel weakness and apathy. She may begin to show signs of anemia: severe dizziness and fatigue.

As a rule, bleeding begins in the second week after the manipulations against the background of childbirth, abortion or after a miscarriage. Scanty discharge in the first week indicates the initial stage of education formation. At 3-5 weeks, the polyp is complete and provokes non-stop bleeding from the uterus.

Symptoms

With a placental polyp, a woman may experience the following symptoms:

• pain in the lower abdomen, often pulling;
• weakness;
• fast fatiguability;
• irritability and overexertion;
• the surface of the skin turns pale.

With belated diagnosis and treatment, an inflammatory process may begin to develop, which is indicated by symptoms such as:

• high body temperature;
• unbearable pain in the uterine region;
• discharge from the genital tract, usually accompanied by a fetid odor;
• burning and itching in the groin area.

Without appropriate treatment, the disease begins to progress and cause various complications in the woman's body. Pathological manifestations can seriously harm health or even lead to death.

If a woman suspects excessive discharge and atypical symptoms, you should seek help from a specialist.

Treatment

Before starting treatment, the disease is diagnosed. An obstetrician-gynecologist examines a woman and studies anamnesis. If neoplasms are detected, an ultrasound of the uterus is prescribed to confirm the diagnosis. With the help of the Doppler ultrasound procedure, it is possible to study in detail the structure of the polyp, and with the help of hysteroscopy, to consider its external component.

Treatment can be carried out in three directions:

1. Polyp removal. The uterine cavity undergoes complete curettage with the help of special instruments or vacuum aspiration is performed. The removed tissue is sent for histological examination.

With heavy bleeding, curettage is carried out on an emergency basis without additional diagnostic procedures.

1. Anemia treatment. In the case of prolonged and heavy bleeding in the blood, the level of hemoglobin and red blood cells decreases. During this period, it is necessary to carry out a procedure to restore the normal level of hemoglobin. For this, the patient is prescribed preparations containing iron and various vitamins.
2. Treatment of infection. Depending on the severity of the pathological process and the type of pathogen, appropriate antibacterial drugs are prescribed.

A timely diagnosed polyp can be effectively treated and does not cause serious complications.

Prevention

After any surgical procedures, a woman needs to undergo a control ultrasound to exclude pathological changes in the uterine cavity.

In order to avoid unpleasant consequences, it is necessary to take a number of preventive measures:

• competently approach the planning of pregnancy;
• to prevent out-of-hospital abortions;
• register at the antenatal clinic in the early stages of pregnancy;
• after childbirth, it is necessary to carry out ultrasound control;
• if there are any signs of a placental polyp, immediately visit a doctor.

The placental polyp is manifested as a result of improperly organized work of the attending physicians, their lack of professionalism or medical errors. In addition, a woman's irresponsible attitude to her health can lead to the emergence of a polyp. Untimely examination in case of suspected diagnosis leads to delayed treatment and possible complications. It is important to conduct annual ultrasound of the uterus to exclude pathologies.