Placenta complications in pregnancy – what you need to know

pregnant tummy close up

The role of the placenta is crucial during pregnancy as it’s responsible for providing the baby with important nutrients for their development. In most pregnancies there are no complications with the placenta, but sometimes issues can arise which can be dangerous for both baby and mum. 

Five kinds of placenta complications: 

1. Placenta abruption

Placenta abruption is when the placenta semi or fully detaches from the uterus wall, causing the mother to bleed and interferes with the supply of oxygen and nutrients to the baby. Without urgent medical attention and in severe cases this can result in death for both the mother and baby.

Other important things to know:

  • Symptoms include: bleeding, ongoing abdominal or lower back pain, a tender and hard uterus, very frequent contractions, and foetal distress.
  • It occurs in one in a hundred pregnancies – however only 25 percent of these cases will be life threatening.
  • Why it happens is largely unknown, although some known causes include abdominal trauma and uterine decompression (when there is a sudden loss of amniotic fluid).
  • Older mothers, those carrying multiple babies, high blood pressure, alcohol and smoking are some of the factors which can increase the risk of placenta abruption.
  • In severe cases: babies can experience brain damage from lack of oxygen, an emergency hysterectomy may have to be carried out, the baby could be stillborn, or the mother’s life could be at risk from extreme blood loss.
  • Planned and emergency c-sections are often required, as the best treatment is for the baby to be delivered immediately, if it’s safe to do so.

2. Placenta praevia

This occurs when the placenta implants either completely or partially over the cervix which then blocks the path for a vaginal delivery. Expecting women with placenta praevia are considered high risk pregnancies and need to be closely monitored, although in most instances babies are delivered safely with no major health implications for the mother.

Things to know about the condition:

  • Chances of having it can be increased by carrying multiple babies, fibroids, high blood pressure and uterine wall scarring (among other things), but there’s no real way to prevent or cure it (until placenta is delivered after birth).
  • The key symptom is painless, bright red bleeding.
  • If just a few spots report it, but if bleeding is substantial you will need a hospital examination (and may need to stay there a few days).
  • If you have placenta praevia you need to avoid sex (as this pushes against the cervix) and remain near the hospital (e.g. don’t travel far).
  • Birth delivery method will be by c-section, in order to prevent extreme bleeding from the placenta as the cervix dilates, with heavy blood loss being dangerous for mum and potentially the baby if severe enough.

3. Placenta accreta

A condition suffered by Kim Kardashian, this is when the placenta attaches too deeply and firmly to the uterus wall, meaning it won’t separate properly once the baby has been born and causes excessive bleeding. Surgery is often required to remove the placenta, and if bleeding can’t be stopped then the uterus has to be removed entirely.

Other details about placenta accreta include:

  • Although very serious, it’s not that common only occurring in about 1 in 7,000 pregnancies.
  • One of the key symptoms is vaginal bleeding during the second trimester, but there is often no signs that a woman has the condition until it is discovered during birth.
  • Uterine scarring from c-sections or previous pregnancies, smoking, fibroids and curettage (such as from termination) are some of the known factors which can increase the risk
  • Around 60-80 percent of all placenta accreta cases occur in women who have previously had c-sections

4. Placental insufficiency

This is when the placenta fails to grow or function properly, meaning insufficient nutrients are provided to the baby which can result in lack of foetal development and low birth weight. There are no known symptoms of placental insufficiency, however the size and health of both the baby and placenta can be detected via ultrasounds ahead of the delivery. The baby may also have fewer movements than normal.  

5. Uterine inversion

A potentially life threatening condition, uterine inversion occurs when the placenta not only doesn’t detach from the uterine wall, but pulls the uterus inside-out when it leaves the body. Thankfully in most cases, the doctor can remove the placenta manually and push the uterus back into position, however sometimes surgery is required and other treatments such as medication and a blood transfusion. A long labour, placenta accreta, short umbilical cord and a weak uterus are some of the known risk factors for the condition; and symptoms include greater than normal blood loss, a drop in blood pressure and the uterus protruding from the vagina.

If you suspect you may have a placenta complication please speak to your doctor immediately.

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