What is the Placenta?
The placenta is an organ that develops in the womb when a woman is pregnant. The placenta helps to provide nutrients and oxygen to the fetus, and helps to remove waste products from the fetus. It also plays a vital role in hormone production and aids in protecting the fetus from bacteria and other infections. The placenta is typically joined to the uterine wall and is connected to the baby by the umbilical cord.
Typically, if the baby is delivered vaginally, the placenta will also be delivered in the same way. Similarly, if the baby is delivered through a caesarean delivery, the placenta will also be removed during the procedure.
There are also many factors that influence and affect the health of the placenta. These factors include:
- Ethnicity
- Smoking
- High blood pressure
- Multiple gestation pregnancy
- Blood-clotting disorders
- History of uterine surgery (eg: caesarean delivery)
- History of previous placental problems or disorders
- Abdominal trauma (eg: from fall or blunt trauma)
- Age (Women over 40 have a greater chance of developing placental problems)
- Premature rupture of amniotic sac (water breaking before labour)
Symptoms of Placenta Disorders include:
- Vaginal bleeding
- Abdominal pain
- Back pain
- Uterine contractions
This article will be focusing on the various placenta disorders.
Placenta Previa (PP)
Placenta previa is a disorder in which the placenta attaches to the lower wall of the uterus that causes the placenta to partially or completely cover the cervix. This condition usually affects mothers in the earlier stages of pregnancy, but fortunately this condition may resolve as the pregnancy progresses. In most cases, if the placenta previa is severe and does not resolve itself, a caesarean delivery will be used to deliver the baby safely.
Placenta Previa can possibly cause vaginal bleeding both before and during birth, which can sometimes be severe and dangerous for the fetus and mother. Other complications of placenta previa may include placental tears, contractions, preterm labour and increased risk for fetal infection. If you suspect you might have placenta previa, do seek medical treatment as soon as possible.
There are mainly three types of placenta previa:
- Marginal placenta previa à the placenta extends to the edge of the cervix
- Complete placenta previa à the placenta fully covers the cervix
- Partial placenta previa à the placenta partially covers the cervix
Placental Abruption
Placental abruption is a condition where the placenta peels either partially or completely away from the inner wall of the uterus before childbirth. This condition is extremely dangerous, because it can deprive the baby of oxygen and nutrients, and cause heavy bleeding in the mother. It is a medical emergency, and would require early delivery.
If you suspect that you may be having a placental abruption, it is important to seek medical attention and treatment immediately.
Placenta Accreta
In normal cases, the placenta will remove itself from the uterine wall after childbirth. However, placenta accreta is a condition where part or all of the placenta will remain firmly attached to the uterus. Placenta accreta arises when the blood vessels of the placenta attach and grow too deeply into the uterine wall. This can possibly cause severe blood loss during delivery, and can be dangerous for both mother and baby.
In severe cases, the placenta might invade the muscles of the uterus, or even grow through the entire uterine wall. If you have placenta accreta, your doctor will most likely recommend a caesarean delivery, followed by the removal of your uterus. This treatment will most likely rule out the possibility of having children in the future, but in most cases is necessary to protect both mother and child.
Retained placenta
A retained placenta occurs when the placenta is not delivered within thirty minutes after childbirth. This condition occurs when the placenta is trapped behind a cervix that is partially closed, or when the placenta remains attached to the uterine wall (placenta accreta). It is important to seek medical treatment immediately if you have a retained placenta, as if left untreated, this condition may cause severe infection or heavy blood loss, which can be life-threatening.
Placental Insufficiency (PI)
Placental insufficiency is also known as placental dysfunction or uteroplacental vascular insufficiency, and it is a condition in which the placenta does not develop properly, or is damaged. This condition is typically recognised when there is a severe reduction in the mother’s blood supply, or when the mother’s blood supply does not increase significantly by the middle of the pregnancy.
Causes of placental insufficiency include diabetes, hypertension, blood clotting disorders and anemia. Placental insufficiency is linked to pre-existing medical conditions related to blood flow, and it may also occur as a result of a placental abruption. Symptoms of placental insufficiency include reduced fetal movement, a smaller uterus (compared to previous pregnancies).
This condition might cause the baby to be unable to receive enough oxygen and nutrients, causing its growth and development to be hindered. This can potentially cause several birth defects, low birth weight, premature birth or even death. In addition, this condition might also put the mother at a greater risk of developing complications, such as preeclampsia (elevated blood pressure, end-organ dysfunction), placental abruption, and preterm labour and delivery. Therefore, it is important to seek medical treatment immediately if you suspect that you have a placental insufficiency.
Placental infarction
Placental infarcts are regions of dead tissue that are found within the placental that are usually caused by blood vessel complications. Around one in four normal pregnancies have minor infarcts, but these do not usually affect the pregnancy. However, if the infarction is serious, it can possibly cause a decrease in blood flow to the affected areas. This could then cause fetal distress and other long-term complications for the baby, such as developmental delays and cerebral palsy. Placental infarction is typically diagnosed through ultrasounds.
Placental disorders can be serious, but many are treatable if caught early. You should always speak with your doctor about any risks or concerns you have during your pregnancy, and be sure to ask about placental disorder treatments if necessary.
Placental disorders can be scary, but by educating yourself and staying in close communication with your doctor, you can help ensure a healthy pregnancy for you and your baby.
If you found this information helpful, please share it with your pregnant friends to help them stay informed throughout their pregnancies.
References
- https://stock.adobe.com/sg/images/id/329759850?as_campaign=Freepik&as_content=api&as_audience=srp&tduid=2feb497796d4cb72e942f548d05ed36b&as_channel=affiliate&as_campclass=redirect&as_source=arvato
- https://stock.adobe.com/sg/images/id/242300163?as_campaign=Freepik&as_content=api&as_audience=srp&tduid=2feb497796d4cb72e942f548d05ed36b&as_channel=affiliate&as_campclass=redirect&as_source=arvato
- https://www.bidmc.org/centers-and-departments/obstetrics-and-gynecology/programs-and-services/pregnancy/high-risk-pregnancy-maternal-fetal-medicine/new-england-center-for-placental-disorders/disorder-types
- https://healthblog.uofmhealth.org/womens-health/5-placenta-issues-every-woman-should-know
- https://www.medicalnewstoday.com/articles/309618#placenta-accreta
- https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/placenta/art-20044425
- https://www.brighamandwomens.org/campaigns/mfm-nicu/disorders-of-the-placenta?cmp=hrgn
- https://www.healthline.com/health/placental-insufficiency#outlook
- https://www.beckerjustice.com/blog/2014/february/what-is-placental-infarction-/