Your pregnancy: the placenta’s role
The placenta plays a crucial role during pregnancy. It is a structure that develops in your uterus during pregnancy. The placenta provides oxygen and nutrients to your growing baby and removes waste products from your baby’s blood. It attaches to the wall of your uterus, and your baby’s umbilical cord arises from it. In most pregnancies, the placenta attaches at the top or side of the uterus.
Various factors can affect the health of the placenta during pregnancy, some modifiable and some not. For example:
1. Maternal age. Certain placental problems are more common in older women, especially after age 40.
2. Premature rupture of the membranes. During pregnancy, your baby is surrounded and cushioned by a fluid-filled membrane called the amniotic sac. If the sac leaks or breaks before labour begins, the risk of certain placental problems increases.
3. High blood pressure. High blood pressure can affect your placenta.
4. Multiple pregnancy. If you’re pregnant with more than one baby, you might be at increased risk of certain placental problems.
5. Blood-clotting disorders. Any condition that impairs your blood’s ability to clot or increases its likelihood of clotting also increases the risk of certain placental problems.
6. Previous uterine surgery. If you’ve had a previous surgery involving your uterus, such as a C-section, you’re at increased risk of certain placental problems.
7. Previous placental problems. If you’ve had a placental problem during a previous pregnancy, you might be at increased risk of experiencing it again.
8. Substance abuse. Certain placental problems are more common in women who smoke or use illegal drugs, such as cocaine, during pregnancy.
9. Abdominal trauma. Trauma to your abdomen — such as from a fall or other type of blow to the abdomen — increases the risk of certain placental problems.
During pregnancy, the most common placental problems include placental abruption, placenta previa and placenta accreta. Each of these conditions can cause potentially heavy vaginal bleeding. After delivery, retained placenta is sometimes a concern.
If the placenta peels away from the inner wall of the uterus before delivery – either partially or completely – it’s known as placental abruption. Placental abruption can cause varying degrees of vaginal bleeding and deprive the baby of oxygen and nutrients. In some cases, early delivery is required.
Another condition occurs when the placenta partially or totally covers the cervix — the outlet for the uterus. Placenta previa can cause severe vaginal bleeding before or during delivery. A C-section delivery might be required.
In placenta accreta, the blood vessels of the placenta grow too deeply into the uterine wall. Placenta accreta can cause vaginal bleeding during the third trimester of pregnancy and severe blood loss after delivery. Treatment might require a C-section delivery followed by surgical removal of the uterus (abdominal hysterectomy).
If the placenta isn’t delivered within 30 to 60 minutes after childbirth, this is known as retained placenta. Retained placenta might occur because the placenta becomes trapped behind a partially closed cervix or because the placenta is still attached to the uterine wall — either loosely (adherent placenta) or deeply (placenta accreta). Left untreated, a retained placenta can cause severe infection or life-threatening blood loss in the mother.
Consult your health care provider during pregnancy if you notice:
1. Vaginal bleeding
2. Abdominal pain
3. Severe back pain
4. Rapid uterine contractions
Most placental problems cannot be directly prevented. However, you can take steps to promote a healthy pregnancy. For example, visit your health care provider regularly throughout your pregnancy; work with your health care provider to manage any health conditions, such as high blood pressure; don’t smoke or use illegal drugs and don’t pursue an elective C-section.
— Mayo Clinic
