Abnormal Placentation: Early Diagnosis is Essential
Oct 17, 2017 - 9:56:33 AM
(HealthNewsDigest.com) - New York, NY, October 17, 2017
– During pregnancy, the placenta is the life support system for the developing fetus. Formed from embryonic cells that burrow into the uterine wall, the placenta passes nutrients, water, oxygen and antibodies against disease from the mother's blood to the fetus. When the placenta, also known as the afterbirth, is delivered a few minutes after the baby is born, it usually weighs about a pound.
“The placenta sustains life for the fetus and is also vital to the health of the mother,” says obstetrician-gynecologist Dr. Kecia Gaither. “A placental abnormality, if not diagnosed and managed, can have devastating consequences for the pregnancy. Early diagnosis is essential to reducing the risk of potential complications.”
What can go wrong with the placenta?
Abnormal placentation generally involves the placement of the placenta in the uterus and/or the depth of its invasion into the uterine wall. The different types include:
- Placenta previa, in which the placenta is attached to the lower part of the uterus and covers all or part of the cervix – the outlet of the uterus and opening to the birth canal. Placenta previa often occurs early in pregnancy and is detected via ultrasound. If the placenta previa is diagnosed in the first trimester, generally, it resolves on its own as the uterus grows. However, if the previa persists, it may cause vaginal bleeding and if present at delivery, a cesarean section is required.
- Placenta accreta, results when the placenta attaches too firmly to the uterine wall. Normally, the placenta detaches easily during childbirth but if the placental tissue has grown too deeply into the body of the uterus, dangerous blood loss is possible during delivery. If the blood vessels penetrate even more deeply – into the muscles of the uterus – the condition is known as placenta increta. If the placenta grows through the uterine wall, known as placenta percreta, it can attach itself to other intra-abdominal organs. All three of these conditions require operative delivery with subsequent hysterectomy to preserve the life of the mother.
Who is at risk for abnormal placentation?
Although a cause of placental abnormality cannot always be precisely determined, risk factors include: previous abnormal placentation; a prior c-section or other uterine surgery; prior endometrial ablation to treat heavy menstrual bleeding; maternal age over 35; smoking; carrying twins, triplets, or more; and having had several children.
What are the symptoms of placental problems?
Early in pregnancy, a placental abnormality is most likely to be detected via ultrasound, usually in the second trimester, and the pregnancy will be monitored closely from that point. In the third trimester, heavy vaginal bleeding may indicate problems with the placenta.
“Most abnormal placentations can't be directly prevented,” says Dr. Gaither. If you're considering an elective cesarean delivery, be sure to discuss with your doctor the possible risks to a future pregnancy. Most importantly, remember that with early diagnosis and close monitoring, placental problems can be successfully managed resulting in excellent outcomes for both mother and child.”
Kecia Gaither, MD, MPH, FACOG, a perinatal consultant and women’s health expert, is a double board-certified physician in OB/GYN and Maternal-Fetal Medicine in New York City. Dr. Gaither is Director of Perinatal Services at Lincoln Medical and Mental Health Center, a member of NYC Health + Hospitals System in Bronx, New York.www.keciagaither.com
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