Placenta Complications During Pregnancy
The placenta is the temporary organ that forms inside the uterus during the pregnancy. It is the fetus life line – the connection between the mother and the baby. This placenta helps to nourish the baby flushes out excess wastes that form throughout the three trimesters of pregnancy. Often referred to as afterbirth, the placenta is formed out of the same cell as the baby is formed of.
The placenta has a number of functions to perform during the pregnancy:
• Nutrient and oxygen supply to the fetus;
• Hormonal support to the fetus;
• Filtrations of the waste products like toxins and smokes away from the blood, although it is not a fool proof filter.
Unfortunately there are certain complications associated with the placenta during pregnancy. Some of these complications can be quite severe and can pose a life or health threat to the mother and the child. These placenta complications are described as follows:
Placental Abruptions:
We all are aware of the fact that placenta is concerned with carrying oxygen and nutrients to the growing fetus. Without the placenta, the fetus cannot leave.
Placental abruption is the condition of partial or complete separation of the placenta from the wall of the uterus. However, the fetus can survive even when half of the placenta remains intact with the uterus. Sometimes, when the abruption occurs during the early pregnancy, the fetus does not grow well and may have serious birth defects.
Signs of placental abruptions are bleeding and contractions, or abdominal pain.
The causes of placental abruptions can be:
• Unknown (usually)
• Use of cigarette or illicit drugs
• Injuries to the abdomen from the car accidents and falls
• A history of abruption in the prior pregnancy
• High blood pressure
• Chronic disease like diabetes.
Placental abruptions can have the following impact on the pregnancy:
• Minor abruptions may irritate the uterus and cause labor before the due date.
- Fetus usually can tolerate minor abruptions well.
- Vaginal bleeding and induced labor are usually safe with minor abruption.
• Massive abruptions may result in
- Early labor and delivery
- Fetal intolerance of labor which may lead to a requirement of C-section.
- Stillbirth
- Massive blood loss that may threaten the mother.
- Inability of the blood to clot, and bleeding from other areas.
Facts about placenta abruptions:
Vaginal bleeding is almost always from the mother and not the baby. However, the baby should be checked for anemia.
In case of placental abruptions, emergency C-section, or blood transfusion or intensive care is required.
About 10% to 17% of women with an abruption will have it in future pregnancy as well.
Placenta Previa
Usually the placenta afterbirth is located at the top of the uterus. However, sometimes the complication arises when the placenta lies in front of the cervix in the lower part of the uterus. This complication is known as Placenta Previa and is diagnosed in up to 5% of pregnancies in 4 months. However, by the time the baby is due, only 0.5% of the pregnant women are left with the complication.
Placenta previa may lead to excess bleeding during the labor. During the labor contraction, the lower part of the uterus changes shape. The placenta is torn away from the uterine wall, thus leading to excessive bleeding. The placenta previa is usually diagnosed by the ultrasound.
Placenta previa may be caused due to:
• Prior caesarean section
• Smoking
• Prior uterine surgery
• Twins, triplets or more
• Diabetes.
Placenta previa can have the following impact on the pregnancy:
Pregnant women with placenta previa probably do not have any symptoms.
• If the cervix is entirely covered with placenta and it remains as such till the delivery period, then the women will need to give the Caesarean birth to the baby as early as 5 weeks before the due date. However, amniocentesis before the C-section will be done to ensure that the baby’s lungs are developed properly.
• Some women need to go to bed rest, which often means no cooking, cleaning, laundry or childcare responsibilities.
• Bleeding, with or without contractions, may be a complication of placenta previa. It should be immediately brought to the notice of the concerned doctor. Such a condition may require blood transfusion or some proper medications, to stop the bleeding at the earliest. Otherwise it can be life threatening for both the mother as well as the child.
Placenta Accreta, Increta & Percreta.
In a normal pregnancy, the placenta attaches itself to the uterine wall, away from the cervix.
• Placenta accreta is a placenta that attaches itself too deeply and too firmly into the wall of the uterus.
• Placenta increta is the condition in which the placenta attaches itself even more deeply into the uterine wall.
• Placenta percreta is a placenta that attaches itself through the uterus, sometimes extending to nearby organs, such as the bladder.
These disorders often cause vaginal bleeding in the third trimester and often lead to premature delivery. Since the placenta cannot separate from the wall of the uterus after delivery, it usually needs to be surgically removed. Often a hysterectomy (uterus removal) is necessary, although there are other surgical procedures that can be used to save the placenta.
