Placental Disorders During Pregnancy

Throughout your pregnancy, it is essential that you receive the proper prenatal health care. Keeping regular health care appointments with your prenatal practitioner can go a long way towards ensuring both you and your baby’s health. Regular appointments can also help to identify any complications that may occur during pregnancy, such as placental disorders. Placental disorders need to be addressed as soon as possible, as they can be very detrimental to both you and your baby’s health.

What is the Placenta?
The placenta is a flat, circular shaped organ that provides a developing fetus with oxygen and important nutrients. During pregnancy, your placenta develops out of the same cells as your baby does, and attaches to the inside wall of your uterus. Blood vessels connect the placenta to your blood supply, allowing your baby to grow and develop throughout pregnancy. Sometimes, the placenta does not form properly or attaches to the wrong part of your uterine wall. Such placental disorders can occur throughout pregnancy, and, if left untreated, may cause serious health complications.

Placental Abruption

Placental abruption is one of the most common placental disorders, occuring in 1 out of 100 pregnancies. It often occurs in the third trimester. Placental abruption happens when your placenta begins to detach from your uterine wall before your baby has been born. There are varying degrees of placental abruption: the placenta can detach in small areas, or it can completely detach from your uterus.

What Causes Placental Abruption?
Unfortunately, the cause of placental abruption remains unknown. Certain factors do seem to contribute to the disorder, including abdominal trauma, premature rupture of the membranes, or smoking during pregnancy.

Symptoms of Placental Abruption
The symptoms of placental abruption include:

  • vaginal bleeding
  • uterine pain or tenderness
  • abdominal pain

Problems Linked with Placental Abruption
Placental abruption is associated with certain complications for both you and your baby. If the placenta detaches completely from your uterine wall, it can deprive baby of oxygen and nutrients, interfering with fetal development, or even causing stillbirth. Women experiencing placental abruption are at increased risk for preterm delivery and newborn complications.

Treatment for Placental Abruption
Treatment depends upon the severity of your abruption and whether or not you are bleeding or experiencing contractions. You will likely be monitored by your health care provider and asked to refrain from strenuous activity. If you are full-term, or if your baby is in distress, a cesarean section may be performed.

Placenta Previa

Also a fairly common pregnancy complication, placenta previa occurs when your placenta lies at the bottom of your uterus, instead of at the top. As a result, your placenta may be lying near to, or covering, your cervix, blocking your baby’s exit passage. If your placenta is covering your entire cervix, it is known as complete placenta previa. If your placenta is only covering part of your cervix, it is known as marginal placenta previa.

What Causes Placenta Previa?
The cause of placenta previa is also unknown. However, it does appear more often in women who:

  • smoke during pregnancy
  • are carrying twins or multiples
  • have had previous uterine surgery or cesarean sections

Symptoms of Placenta Previa
Typically, placenta previa is associated with very few symptoms. It is usually found during routine prenatal testing. Placenta previa sometimes causes vaginal bleeding.

Complications Associated with Placenta Previa
Because placenta previa blocks the entrance to the cervix, it can cause serious problems as your baby grows and prepares for birth. It is possible for your placenta to tear, leaving your baby open to infection. A torn placenta may also cause severe bleeding and contractions, which could lead to preterm birth.

Treating Placenta Previa
90% of placenta previa cases resolve without treatment. Your health care provider will monitor you with ultrasounds to check and see if your placenta moves back to the top of your uterus. If the condition does not rectify itself and you begin to suffer from contractions, your health care provider may decide to take action.

A cesarean section may be recommended to full-term women in order to prevent any possible bleeding. If you have not reached 34 weeks yet, your health care provider may give your baby corticosteroids to increase lung capacity, or she may perform an emergency cesarean section.

Placenta Accreta

Placenta accreta occurs when your placenta attaches too firmly to the inside wall of your uterus. This is a rare disorder, occurring in only 1 in 5000 pregnancies, and is associated with serious complications. There are three variants of placenta accreta:

  • Accreta: This occurs when your placenta has attached to the muscle inside your uterine wall.
  • Increta: This occurs when your placenta has attached through the muscle in your uterine wall.
  • Percreta: This occurs when your placenta pushes through your uterine wall and attaches to other organs, like the bladder.

What Causes Placenta Accreta?
Unfortunately, the cause of placenta accreta and its variants are unknown. The condition does appear to be more common in women who have placenta previa or have experienced previous cesarean sections.

Symptoms of Placenta Accreta
Symptoms of placenta accreta manifest during labor and delivery. In particular, it is associated with massive uterine bleeding and contractions.

Complications of Placenta Accreta
Placenta accreta is connected with severe complications. Because the placenta is so firmly attached to the uterus, it can make it difficult for you to deliver the placenta after you have given birth. It is possible that the uterus will become damaged or torn as you try to pass the placenta afterbirth. Placenta accreta also causes those contractions that occur after labor to stop. These contractions play a role in minimizing blood loss. As a result, placenta accrete can cause serious hemorrhaging.

Treatment for Placenta Accreta
If you appear to be suffering from placenta accreta, your health care provider will attempt to coax your placenta out from your uterus after birth. If this is not possible, you may require a hysterectomy in order to prevent massive bleeding. If placenta accreta is diagnosed prior to birth, you may be given a cesarean section. This will help to minimize blood loss.

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