BEWARE OF PLACENTA COMPLICATIONS during pregnancy and birth

The placenta or afterbirth refers to the organ that connects the developing foetus to the uterine wall of the mother through the umbilical cord. Though not discussed as extensively as it should, the placenta’s role is not any more diminished and just as equally, should not be underestimated. We give you placenta-related complications to watch out for.

A well-developed placenta lies at the core of a successful pregnancy as it serves not only as the growing foetus’ lifeline but also as an efficient plumbing system.

Its various functions include allowance of nutrient uptake by the baby from the uterine wall, waste elimination, gaseous exchange, production of pregnancy-relevant hormones and fighting infections.

Unfortunately, there are instances when proper development of the placenta is hampered leading to pregnancy complications that can also be life threatening. Some factors that can lead to complications related to the placenta include:

Age: Women aged 35 years and above are more prone to obstetric complications than younger women.

Previous or existing conditions: Surgeries such as Caesarean section, removal of fibroids, previous     placenta-related complications and substance abuse and smoking increase one’s risk of complications.

High blood pressure: Hypertension causes less blood to flow through the placenta, delivering less oxygen and fewer nutrients to the growing foetus.

Multiple pregnancies: In multiple pregnancies, detachment of the placenta may occur after the vaginal delivery of the first child leading to other babies being delivered through Caesarean sections.

Blood-clotting disorders: Any condition that impairs your blood’s ability to clot or increases its likelihood to clot far more than is required increases the risk of problems such as hemorrhaging or embolism in the membranes and blood vessels.

Premature rupture of the membranes (PROM): This refers to when the amniotic sac leaks or breaks before labour, increasing the risk of the placenta detaching.

Abdominal trauma: A fall or other type of blow to the abdomen increases the risk of the placenta detaching.

Complications related to the placenta

Placenta abruption: This is when the placenta partially or completely detaches from the uterine wall prior to delivery leading to premature birth or even death of the baby.

It is common in late term pregnancy but can be detected as early as four months. In most cases, it is the cause of late term bleeding in pregnancy. Symptoms include sudden-onset of abdominal pain, rapid and continuous contractions, tenderness in the abdomen, bleeding and decreased foetal movement.

If one’s due date is close, then the baby can be delivered normally. However, if it is early in the pregnancy, or the baby is in distress, then a Caesarean section is the recommended action.

Placenta previa: This is when the placenta lies low on the uterus blocking the cervix or birth canal. During early pregnancy, the placenta starts out lying low but as the pregnancy grows, the placenta shifts away from the cervix.

Main symptoms include sudden bleeding towards the end of the second or early third trimester and cramping. There are three main levels of placenta previa.

Marginal – the placenta is next to the cervix but does not cover the opening hence natural birth is still possible.

Partial – the placenta covers part of the cervix. Complete – the placenta covers the entire cervical opening necessitating a Caesarean section.

The following are the forms of placenta previa:

Placenta accreta: This is a rare complication of placenta previa where the placenta embeds itself too deep into the womb and stays put after delivery instead of detaching.

It can lead to serious post-delivery bleeding, which, if remains uncontrolled, may necessitate a hysterectomy. A Caesarean section is the recommended course of action.

Vasa previa: This is also a rare type of placenta previa where blood vessels within the placenta or umbilical cord run out of the placenta and cord membranes and cover the cervix. The condition is highly prone to haemorrhage due to the exposed blood vessels tearing especially during delivery.

Some cases can be hard to detect but according to doctors, if one notices bleeding during the second trimester, especially dark red blood (low oxygenated blood) then one should immediately consult a doctor.

If detected early, the condition can be managed, with a caesarean section being done at 35 weeks. Attempting normal delivery can be fatal to the foetus due to the rapture of the vessels.

Retained placenta: This refers to a condition where the placenta still does not detach 30 minutes to one-hour post birth. This occurs because of placenta accreta or when the placenta is trapped behind a partially closed cervix.

If left undetached, the placenta can lead to an infection or excessive blood loss to the mother. The recommended course of action includes injections to help the mother’s womb contract and expel the placenta naturally or a midwife may have to pull it out by hand.