Placental Problems and Their Impact on Birth: A Deep Dive into Placenta Abruption, Previa, and More

The placenta is a structure that grows in a woman’s uterus when she is pregnant. It is attached to the uterine wall and delivers nutrients and oxygen to the growing baby through the umbilical cord. It also removes waste from the baby’s blood supply. The placenta is normally connected to either the side, top, back, or front of the uterus. In rare instances, the placenta may be attached to the lower part of the uterus; a condition known as placenta previa (low-lying placenta).

What Factors Can Affect the Health of the Placenta?

Multiple factors can impact the health of a placenta during gestation, including: 

• Maternal age: Problems with the placenta occur more frequently in women over the age of 40
• Water breaks too early: While he or she is growing, a baby is cushioned and surrounded by a fluid-filled membrane known as the amniotic sac. If this membrane breaks or leaks before labor starts, the risk of certain placental problems greatly increases
• High blood pressure: Woman with high blood pressure are extremely prone to issues with their placenta  
• Multiple pregnancies: Carrying more than one fetus (twins, triplets, etc.) can increase the odds of placental problems arising
• Blood-clotting conditions: Any disorder that either increases the likelihood of a blood clot or hinders the blood's ability to clot can increase the risk of some placental problems.
• Prior uterine surgery: Prior uterine surgery, such as the removal of fibroids or a C-section increases the chances of issues with the placenta 
• Prior placental problems: The odds of placental problems are higher in women who have previously had them  
• Substance use: Specific placental issues arise more frequently in women who used cocaine or smoked while they were pregnant 
• Abdominal trauma: Any previous trauma to the abdomen, such as from a car accident, fall, or assault, greatly increases the odds of the placenta separating from the uterus prematurely, a condition known as placenta abruption

What Placental Problems Occur Most Often?  

During pregnancy, the most frequently occurring placental problems are placenta accreta, placenta previa, and placental abruption. Post-delivery, retained placenta can be a concern.  

• Placenta accreta: Under normal circumstances, the placenta separates from the uterine wall once the baby is born. When placenta accreta occurs, however, all or part of the placenta remains connected to the uterus. This condition can develop if the blood vessels and other placental parts attach too deeply to the uterine wall. 

Placenta accreta often causes severe blood loss during the delivery process. In severe cases, the placenta grows down into the uterine muscles of through the uterine wall. Your doctor will recommend a C-section followed by the removal of the uterus.

• Placenta previa: This medical condition arises when the placenta completely or partly covers the cervix. Placenta previa develops most often early in the pregnancy and could potentially resolve itself as the uterus expands.
  Placenta previa can result in heavy vaginal bleeding throughout the pregnancy or during delivery. Whether this condition can be successfully managed depends on the severity of the bleeding, whether it can be stemmed, how far along the pregnancy is, the placenta’s position, and the overall health of mother and baby. If placenta previa persists into the third trimester, the doctor should recommend a C-section.
• Placental abruption: A condition called placental abruption can develop in cases where the placenta either fully or partially peels away from the uterus prior to delivery. Placental abruption can deprive the baby of nutrients and oxygen and cause the mother to bleed heavily. This condition can result in an emergency that requires premature delivery.
• Retained placenta: A retained placenta occurs when the mother does not deliver the placenta about 30 or so minutes after the birthing process. A retained placenta can develop if the placenta is still attached to the uterine wall or it becomes lodged behind a partly closed cervix. If left untreated, a retained placenta can lead to a serious infection or catastrophic blood loss.

What Symptoms Can Indicate Placental Problems?

If you experience any of the following during pregnancy, consult your doctor right away:  

• Abdominal pain
• Vaginal bleeding
• Uterine contractions
• Back pain

How Is the Placenta Delivered?

When a baby is delivered vaginally, the placenta is delivered vaginally as well. This is referred to as the third stage of labor.  Once the mother has given birth, she will continue to experience mild contractions. The doctor might administer the drug Pitocin (oxytocin) to help the uterine contractions continue and minimize postpartum bleeding. For those giving birth via a C-section, your doctor will remove the placenta during the procedure. Once it has been expelled, the placenta will be examined to ensure that it is intact. If any pieces were left behind, they would have to be removed to prevent infection and unnecessary bleeding. In most cases, the doctor will let you take the placenta home with you, should you be interested in doing so. 

How Can I Lower the Risk of Placental Problems Developing?

The majority of placental problems cannot be directly prevented but there are steps you can take to help ensure a healthy pregnancy:

• Visit your doctor regularly for the duration of your pregnancy. Reschedule any missed appointments.
• Work with your birthing team to manage any health problems, like diabetes and high blood pressure.
• Do not smoke, drink, or take drugs while you are pregnant.
• Before opting to pursue an elective C-section, discuss all potential risks with your doctor. 

If you experienced placental problems during an earlier pregnancy and are planning another, talk to your doctor about how you can reduce the risk of it happening again. You should also tell them if you have had any type of uterine surgery in the past.  Both of these will require your condition to be closely monitored throughout your pregnancy.  

If you have concerns regarding potential placental problems during your pregnancy, talk to your doctor. They can provide you with additional information on the role the placenta plays during your pregnancy. If your child sustained a birth injury and you have questions regarding filing a claim, consult with a Dallas birth injury lawyer from Rasansky Law Firm. We offer a free initial consultation and can advise you on how to best proceed with your birth injury case. Call us at (214) 651-6100 or fill out the contact form on our website to schedule your free consultation.