Placenta disorders
During pregnancy the placenta is essential for supporting foetal health. It filters foetal waste, prevents infections and provides nutrients and oxygen to the developing baby. This organ also is important for supporting hormone production.
Normally the placenta will attach to the side or top of the uterine wall. In some cases it attaches abnormally or fails to grow properly. These situations can cause health problems for the developing foetus and the mother.
This feature article will discuss risk factors for placenta disorders, the types of disorders and how to mitigate these complications
Risk factors contributing to placenta disorders
Lifestyle, medical history and ethnicity can contribute to the development of placenta disorders. Although some risk factors are fixed (such as ethnicity and maternal age), there are other influences that can be mitigated. By understanding the factors that contribute to these disorders it is possible to make lifestyle changes prior to conception to improve health outcomes.
Common risk factors include:
- Cigarette smoking
- High blood pressure
- Blood-clotting disorders
- Previous uterine surgery
- Substance abuse
- Abdominal surgery or trauma
- Ethnicity
- Diabetes
- Blood thinning medications
- Multiple gestation pregnancy
- Late maternal age (40 and over)
CONDITION: Placenta previa
This condition is characterised by the placenta attaching too low and partially or fully covering the cervix. This condition affects up to 1% of pregnancies. In many cases it resolves itself. Potential complications include placental tear, vaginal bleeding, early labour and increased risk of foetal infection. A caesarean delivery is often required to safely deliver the baby.
CONDITION: Placental abruption
In some cases the placenta can separate away from the uterus. This separation can be partial or complete. High blood pressure is a significant risk factor in this condition. Like placenta previa, this condition affects 1% of pregnancies.
Placental abruption is the leading cause of newborn and foetal death. This condition also contributes to foetal growth abnormalities and premature delivery. When the placenta separates the foetus is deprived of oxygen and nutrients.
CONDITION: Placental insufficency
When the placenta fails to function correctly it can restrict foetal growth and result in lower birth rates. This occurs when nutrient and oxygen supply is restricted. This condition may lead to pre-eclampsia, preterm labour and deliver, or placental abruption.
Pre-eclampsia
This condition affects one in twenty pregnancies. Left untreated, this condition can be life-threatening. Pre-eclampsia is characterised by edema, headaches, weight gain, and high blood pressure.
CONDITION: Placenta accreta
This condition occurs when the placenta and associated blood vessels grow deeply into the uterus walls. This condition affects 1 in 2,500 pregnancies. It can result in vaginal bleeding, caesarean delivery, postpartum haemorrhage, and subsequent hysterectomy.
Diagnosis & Management
Attentive pre-natal care is important to help support a healthy outcome for both mother and baby. While most placenta disorders cannot be directly prevented, there are steps that can be taken to reduce risks. If you have several of the risk factors mentioned at the start of this article it is important to routinely have ultrasounds to measure the size of the placenta and foetus. Regular bed-rest and consultation with a high-risk maternal foetal specialist is also recommended.
Positive lifestyle choices
There are many positive lifestyle choices that can be taken to promote a healthy pregnancy. In addition to regular visits to your healthcare provider it is important to manage conditions such as high blood pressure, diabetes, and certain medications that can increase risk factors. Not smoking or taking illegal substances is also very important. Also, ensure that you understand the possible risks if you choose to have an elective c-section and want more children.
Healthy nutrition
Limiting stress and maintaining a healthy diet throughout pregnancy is important. There are certain nutrients the body needs in higher concentrations during pregnancy that will help to support a healthy placenta and foetus.
Female Fertility NutrientsWarning signs
Always contact your doctor during pregnancy if you experience bleeding, vaginal leaking, abnormal cramping, high fever, persistent headaches, excessive thirst, blurred vision, swollen arms or legs, or a reduction in foetal movement. These symptoms may be an indication of an undiagnosed problem. Early medical intervention is important.
Dr. Kooner is Deputy Director of The Advanced Fertility Center of Chicago and has been a Specialist in Fertility Treatment since 1999.
As well as the areas that the clinic specialises in general, he is particularly interested in managing oocyte donation, female same-sex couples, single women having sperm donation and those considering egg freezing.
Dr. Kooner regularly speaks at fertility meetings. He has published in national journals and constantly contributes to the fertility research and publications from Advanced Fertility Center of Chicago.