During pregnancy, in your scan report, you will notice the placenta is anterior, posterior, etc. Sometimes you might notice it would be mentioned as a low-lying placenta and your doctor would advise you to not exercise or avoid certain activities. And certain times your doctor would say, you have placental insufficiency and a c section has to be planned. So what are these placental disorders? What should you do and what should you avoid if you have any of those? To understand all these read below.
Now let’s get into the basics first
What is a placenta?
The placenta is an organ that connects the mother and the baby. It helps in transporting oxygen as well as nutrients to the baby in the womb. Sometimes however it positions itself wrong or at times blood flow to the placenta is restricted acutely or chronically. All of these result in various placental disorders that complicate the pregnancy.
Who is at risk of getting placental disorders?
Women who fall under the following criteria are at risk of having placental disorders:
(1) History of smoking
(2) History of other substance abuse
(3) Having high blood pressure
(4) Multiple pregnancies
(5) History of placental disorder in previous pregnancies
(6) Fall or trauma to the abdomen
(7) History of surgery in the uterus priorly
(8) History of blood clotting issues
(9) History of repeated instrumental abortions
Ok, so what are the various placental disorders?
1. Placenta previa
Commonly known as “Low Lying Placenta”. It affects 1 in 200 women. It is where the placenta attaches very low, sometimes covering up the cervix partially or even completely. It results in bleeding even without a provoking factor. The placenta migrates up in most cases but in case it persists till the third trimester then usually your doctor will plan for a C section for a safe delivery. The placenta previa cannot be treated but it requires close observation and uncontrollable or recurrent bleeding, premature contractions may cause premature birth.
Do’s and Don'ts: Rest is the major thing you need while having placenta previa. Seek help from your healthcare provider immediately in case you experience bleeding. Avoid intercourse, traveling, and exercising. Avoid standing for a long time, lifting weights, and strenuous activities. Breathing exercises can be done. Walking should be started only if your doctor advises you to do so.
2. Placental insufficiency
Sometimes the placenta does not function properly, resulting in less oxygen and nutrient supply to the baby. Since the baby is not getting adequate food the growth might be restricted, you will notice smaller bump than normal and fewer movements. Babies born with placental insufficiency usually have low birth weight. If left untreated it could cause learning disabilities, cerebral palsy, and low sugar levels in the baby. The earlier placental insufficiency occurs, more is the complication. Usually induction of labor will be planned in case of placental insufficiency but there is also high risk of still birth to occur. Hence the mother in labor with placental insufficiency will be closely monitored and many times they may require C-section. There is no definitive treatment for placental insufficiency at present but there are some supportive treatments available. The only way to avoid complications is to take good antenatal care and early diagnosis. Few symptoms of placental insufficiency include reduced weight gain, high blood pressure, and swelling of the feet. If you experience any of these your health care provider might ask you to take a scan to rule out placental insufficiency.
Do’s and Don’ts: Monitor your bp regularly and keep your sugar levels in control. Take a good and balanced diet, especially include green leafy vegetables. Being on bed rest is important. And frequent ultra sound follow up as suggested by doctor is also crucial.
3. Placental abruption
Placental abruption is where the placenta suddenly separates from the uterus it could be partial or complete. This is most common in the third trimester and occurs in 1 in 100 pregnancies. The major cause of abruption is uncontrolled hypertension, and injury or direct trauma to the abdomen may also cause the abruption. It also cuts off nutrient supply and oxygen to the baby, causing acute compromise of blood supply to the baby. There is a high risk of premature delivery in women with placental abruption. Symptoms of placental abruption are vaginal bleeding, pain in your tummy, and abnormal and continuous contractions.
Do’s and Don’ts: Bed rest is recommended. Your doctor might provide certain medication to mature the baby’s lungs since there is a high risk of premature delivery. Avoid high intensity exercises. Avoid being in a situation where there is a risk of trauma and fall. Eg: Avoid climbing, traveling without seatbelts in a car, etc. Keep your blood pressure under control and repeat immediately if your home BP recordings are high and report to the hospital if you experience rupture of membranes as sudden decompression of the intra-abdomen pressure can also cause abruption. Avoid smoking, alcohol consumption and drug abuse.
4. Placental infarcts
It is a condition where microscopic blood clots get deposited under the placenta blocking the nutrient supply to the baby. Again, due to the lack of nutrients the growth of the baby is restricted. In severe conditions, if left untreated it can even lead to the death of the baby in the womb. This condition occurs in women with high blood pressure or patients with coagulation disorders and smokers.
Do’s and don’ts: Your doctor will perform an ultrasound more frequently if you have this condition. Following up whenever suggested is necessary. Along with this monitoring your bp regularly is also important. Avoid smoking and drug abuse.
5. Placenta-Uterus attachment disorders:
The placenta which has to connect the uterus and the baby sometimes gets attached to the uterus itself either partially or completely. In 1 in 2500 women, it sometimes even gets attached to other organs like urinary bladder or intestine. C-section will be planned in this condition since it results in severe bleeding if normal delivery is performed. It occurs in women who had multiple C-sections, prior uterine surgeries, and multiple curettages priorly. There is no other treatment option for this other than electively planning the C-Section by senior obstetrician and trying to remove the placenta gently. Still this kind of elective C-Sections may be critical as it may cause torrential hemorrhage.
Though there are no treatment options available for placental disorders it is important that every pregnant woman must be aware of these so that they will be extra precautious. Monitoring bp regularly, keeping sugar levels in control, and bed rest are the things that could be done to avoid any further complications. In case you experience vaginal bleeding, fewer baby movements, or any other abnormal symptoms when you have placental disorders, it is important to visit the doctor as soon as possible since if ignored it could turn into a life-threatening condition for both the mother and the baby.
