During pregnancy, one of the most important things your care team will monitor is the health of the placenta. A temporary organ that develops shortly after conception, the placenta supports your growing baby. While rare, complications can arise. We're exploring some of the more common placental complications, along with the treatment to help ensure a safe birth experience and a healthy baby.
The Role of the Placenta during Pregnancy
The placenta is an organ that develops seven to ten days after conception. It attaches to the wall of the uterus, connecting to your baby via the umbilical cord. The placenta provides the nutrients, oxygen, and hormones necessary for growth and development, helps remove waste and carbon dioxide from baby's blood, and passes antibodies from you to your baby for protection from illness.
Common Placenta Conditions or Disorders
While most pregnancies progress without placental complications, a small percentage of expecting people may be diagnosed with a complication that could impact the health of baby or mother. Some common conditions include:
- Placenta Previa occurs when the placenta partially or completely covers the cervix, the opening of the uterus. Placenta previa can cause bleeding, especially during the later stages of pregnancy. If diagnosed with placenta previa, your health-care provider will monitor the condition closely and may recommend modified activities and bed rest. Placenta previa almost always results in a C-section delivery in order to keep both mother and baby safe during childbirth.
- Placental Abruption occurs when the placenta detaches from the uterine wall before baby is delivered. This can result in heavy bleeding and potentially compromise the baby's oxygen supply. If you experience sudden, intense abdominal pain or vaginal bleeding, seek medical attention immediately.
- Placenta Accreta occurs when the placenta attaches too deeply into the uterine wall. After childbirth, the placenta typically separates from the uterine wall. With placenta accreta, it remains attached. This can lead to complications such as excessive bleeding that could require surgery and a prolonged hospital stay. It's essential to work closely with your medical team if you're diagnosed with any placenta accreta spectrum disorder. The Penn Medicine Placenta Accreta Spectrum Center of Excellence in Philadelphia is a valuable resource that specializes in managing and providing personalized care. If you are diagnosed, you may be referred to Penn Medicine in Philadelphia to access the services at the Placenta Accreta Spectrum Center of Excellence.
- Placental Insufficiency occurs when the placenta is unable to provide sufficient nutrients and oxygen to the baby. A placenta may not function as well as it should for several reasons, including having an abnormal shape, not attaching to the uterine wall correctly, or not growing large enough (particularly in multiple pregnancies). Placental insufficiency can result in slower growth and development of the baby, and is often detected through regular ultrasounds and monitoring. Your health-care provider will guide you on necessary interventions, such as more frequent check-ups and possible lifestyle adjustments as needed.
- Cord Insertion Complications depend on where and how the umbilical cord attaches to the placenta. A marginal cord insertion occurs when the umbilical cord attaches on the side, instead of the middle, of the placenta. A velamentous cord insertion happens when the umbilical cord attaches to the outside membranes of the placenta, rather than the inside, causing the blood vessels to remain unprotected and possibly restrict blood flow or oxygen to baby. While rare, either condition can result in fetal growth restriction or even preterm labor.
Signs and Symptoms of a Placental Disorder
The most common sign of a placenta complication or disorder is bleeding from the vagina, although not everyone with a placental complication experiences bleeding. Always talk to your provider about other symptoms such as abdominal pain, contractions, or discomfort.
In some cases, there are no physical signs or symptoms of a placental disorder, and the condition may be diagnosed during a routine anatomy ultrasound. During this ultrasound the placenta, umbilical cord, and blood flow to and from baby will be examined in order to identify any potential problems. Similarly, if baby is measuring small for their due date, it could be a sign there is an issue with the placenta.
Treatment of Placenta Complications
As with any pregnancy complication, treatment and management depend on the condition and how severe it is. In all cases your provider will monitor your and your baby's health closely, and you may have more frequent ultrasounds. Other treatments could include bed rest, pelvic rest (avoiding sex, exercise, or lifting heavy objects), or an early or C-section delivery.
We know being diagnosed with placental complications can be concerning. Know that medical professionals, such as those at the Penn Medicine Placenta Accreta Spectrum Center of Excellence, are dedicated to providing you with the best care possible. Maternal fetal medicine specialists across Penn Medicine practices are experienced in managing placental complications, providing accurate diagnoses, personalized treatment plans, and ongoing support throughout your pregnancy.