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Placenta Issues

Placenta issues are complicated.  We aren’t always sure why they occur in some pregnancies.  We do know that having a cesarean, prior uterine surgery or a previous placenta issue increases your chances for future placenta issues.  This doesn’t mean the past will repeat itself, just that there can be a slightly higher risk for those mothers.

For an overview of all the major placenta issues that can occur visit the March of Dimes site.  We have listed some of the more obvious ones:

Anterior placenta

Anterior placenta is not precisely a medical condition but more of a description of the location of the placenta.  Some physicians and midwives are concerned when a previous cesarean mom has a low anterior placenta due to the position of the uterine scar but this is not a contraindication for VBAC.

Low-Lying Placenta/Placenta Previa

When the placenta is low in the uterus and close to the cervical opening or os, it is usually called low-lying placenta and is watched to see whether or not it is a risk during labor.  Placenta previa, however, is when the placenta is covering part or all of the cervix and usually means the mother will have to deliver by cesarean in an attempt to prevent labor and possible placental abruption.

Placenta Accreta/Placenta Increta/Placenta Percreta

Once again, the March of Dimes site has an excellent overview on these conditions.

Subchorionic Hemorrhage

Subchorionic hemorrhage (SCH) is bleeding underneath the placenta.  Many women experience this early in pregnancy in the form of spotting and the SCH is confirmed via ultrasound.  Most of these hemorrhages resolve and disappear as the blood is reabsorbed by the mother’s system.  Mothers who have had an SCH should be aware that they are indicated as a risk factor in miscarriage, extreme pre-term labor and pre-term labor.  Feelings of early contractions or concerns about feelings of dilation should be  brought up with your care provider.  For more information on subchorionic hemorrhage and actual ultrasound images, this articlemay be helpful.

Placental Abruption

Separation of the placenta from the uterine wall is commonly called placental abruption.  Abruptions can be partial or complete, meaning that only a part of the placenta comes loose or that the entire placenta lets go.  The release of the placenta while the baby is still in the womb cuts off its blood flow and oxygen and the baby must be born immediately.  For mothers who have a partial abruption, usually they are placed on bed rest in the hospital in order to keep an eye on how the baby is doing and to be watchful for more bleeding which would indicate further separation.

Placental Insufficiency and concerns for Postdates

Often used to encourage mothers to induce labor, placental insufficiency is not as common as one would think.  Since many times women are told that going past 40 weeks means they are overdue, we’ve included this page on placental grading from the gentlebirth.org archives which includes studies, obstetrician and midwifery opinions and descriptions of later term pregnancies and babies. Placentas are designed to support life and do their jobs very well.

Other Concerns

Other concerns for placentas may include the insertion or placement of the cord into the placenta itself. In almost all cases, these insertions will be found after a normal delivery. For a more detailed look via ultrasound, here is a link on battledore, velamentous and other insertions.

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