3 Placenta problems explained

If the organ that nourishes the foetus during pregnancy malfunctions, it’s important to diagnose and fix the problem quickly, say experts. By Xanet van Vuuren


The placenta is the only organ in the body that’s vital for only nine months before your body discards it. Acting as your baby’s lungs, kidneys and digestive system while he’s in your womb, the placenta’s main function is to supply oxygen and nutrients and to protect your little one from infection.
The placenta is literally your baby’s lifeline, so it’s essential to nip any problems in the bud right away.

Obstetrician and gynaecologist Dr Johann Möller explains three of the most common placental problems and what they can mean for you and your baby’s health.

Placenta praevia

Placenta praevia occurs when the placenta develops in the lower part of the womb near the cervical opening and covers all or part of the opening to the cervix. This condition prevents your baby from entering the birth canal properly during labour and delivery, which means that you’ll need a C-Section.

“Luckily, it only occurs in about 1 in 200 pregnancies and often corrects itself. Only about 10% of pregnant women still have placenta praevia by the time they have to deliver,” says Möller.

Symptoms, diagnosis and treatment of placenta praevia
Placenta praevia usually is diagnosed with an ultrasound. You may not show symptoms of placenta praevia, but there are warning signs you can look for:

  • Sudden, painless vaginal bleeding
  • Premature contractions and aches or pains in your lower back or tummy.

Your treatment will depend on how much you’re bleeding, how the problem is affecting your and your baby’s health, and how close you are to your due date.

Who is at risk of placenta praevia?

  • Moms diagnosed previously with placenta praevia
  • Previously pregnant moms
  • Moms carrying multiples
  • Moms older than 35
  • Drug users
  • Moms who’ve had previous uterine surgery.

Placental abruption

A placental abruption causes the placenta to partially or completely separate from your uterus before your baby is born. This condition can be dangerous for both you and your baby.
“The detached areas of the placenta are unable to deliver oxygen and nutrients to your baby, who is then dependent on the remaining placental unit, which may or may not compensate for the loss in function,” says Möller.

Signs and symptoms

  • Vaginal bleeding and possible abdominal pain
  • Uterine tenderness
  • Rapid contractions and possible premature labour.

Who is at risk of placental abruption?

  • Moms with high blood pressure
  • Moms with small babies for their gestational age
  • First trimester drug users
  • Moms with a history of previous abruption
  • Moms over 35
  • Moms with abnormalities in the uterus.

Treating placental abruption
The type of treatment will depend on the severity of the separation, the location of the separation and how far along you are in your pregnancy. There’s no way to stop a detaching placenta, and no way to reattach it. This means your baby will have to be delivered if the placenta is completely separated.

Placenta Accreta

When your placenta attaches itself too deeply into the wall of your uterus, it’s known as placenta accreta, placenta increta, or placenta percreta. This condition occurs in about 1 in 2 500 pregnancies and seems to be related to placenta praevia and previous caesarean deliveries.

According to the American Pregnancy Association, placenta accreta is present in 5-10% of moms with placenta praevia.
Placenta accreta is caused when the placenta attaches itself too deeply in the uterine wall without penetrating the uterine muscle. This is the most common condition and accounts for about 75% of all cases.
Placenta increta occurs when the placenta is attached so deeply into the uterine wall that it penetrates the uterine muscle. This condition is less common and only accounts for about 15% of all cases.
Placenta percreta is the least common of the three conditions, occurring only in about 5% of all cases. This condition occurs when the placenta penetrates through the uterine wall and attaches to another organ such as the bladder.

Signs and symptoms
Pregnant women with this condition usually don’t show any signs or symptoms before the birth of their baby. However, bleeding during the third trimester may be a warning sign of placenta accreta. This abnormality can, however, often be diagnosed during a routine ultrasound examination of the placenta before birth or pre-delivery. Placenta accreta can lead to premature delivery and subsequent complications for the baby if it is not managed properly.

Treating placenta accreta
Although placenta accreta cannot be remedied, your doctor can use medication, bed rest and any other means necessary to help continue your pregnancy to full term, so if it happens to you, stay positive and remain calm.

When to call your doctor
Call your doctor immediately if you experience any vaginal bleeding during your pregnancy. Placenta problems must be diagnosed as soon as possible in order to start treatment.

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