Placenta Condition:

The placenta is a structure that develops inside the uterus during pregnancy. It forms from the same cells as the embryo and acts as an unborn babys life-support system. One side of the placenta attaches to the wall of the uterus and connects to the mothers blood supply. The other side connects the baby to the placenta through the umbilical cord.

 The placenta supplies the baby with nutrients and oxygen from the mothers blood. It also removes waste from the babys blood and puts it into the mothers blood. The mothers kidneys dispose of the waste. The placenta also produces hormones that play a role in starting labor and help protect the baby from infections and harmful substances. After a woman gives birth, the placentas job is done. It comes out after the baby is born and is called the afterbirth.

 The mature placenta is flat and shaped like a circle. It weighs about 1 pound. But sometimes the placenta: Is not formed correctly Is not in the right place in the uterus Does not work correctly

Kinds of Placental Problems

1. What is placental abruption?
Placental abruption (sometimes called abruptio placentae) is a condition in which the placenta peels away from the uterine wall, partially or almost completely, before birth. Mild cases may cause few problems, but severe cases can deprive the baby of oxygen and nutrients. Severe cases also can cause bleeding in the mother that can be dangerous to her and the baby.

How common is placental abruption?

(1).Abruption occurs in about 1 in 100 pregnancies. (2). It occurs most often in the third trimester, but it can happen any time after about 20 weeks of pregnancy.

 What are the symptoms of abruption?

The main symptom of placental abruption is vaginal bleeding. If a pregnant woman has vaginal bleeding, she should contact her health care provider. She also may have uterine discomfort and tenderness or sudden, continuous abdominal pain. In a few cases, these symptoms may occur without vaginal bleeding because the blood is trapped behind the placenta.

 How is placental abruption diagnosed? If a provider thinks a woman is having an abruption, he may recommend that the woman go to the hospital for a complete evaluation. The woman gets a physical exam and, most likely, an abdominal ultrasound. An ultrasound can detect many, but not all, cases of abruption.

 How is placental abruption treated?

A womans treatment depends on the severity of the abruption and her babys gestational age (weeks of pregnancy). A mild abruption usually is not dangerous. If a woman has a mild abruption at or near term (37 to 41 weeks), her provider may recommend immediate delivery by inducing labor or cesarean birth (c-section). Giving birth immediately can help avoid risks associated with the abruption getting worse. If the woman needs to give birth immediately, her provider may recommend treatment with drugs called corticosteroids. These drugs help the babys lungs mature and reduce the risk of prematurityrelated complications and infant death. A woman may need to give birth immediately, often by csection, if: A mild abruption gets worse. She is bleeding heavily.

What causes placental abruption? High blood pressure Cocaine use Cigarette smoking Abdominal trauma from something like a car accident or physical abuse Certain abnormalities of the uterus or umbilical cord Age older than 35 Pregnant with twins, triplets or more Premature rupture of the membranes (PROM) Infections in the uterus

What is the risk of an abruption happening again in another pregnancy? A woman who has had an abruption has about a 10-percent chance of it happening again in a later pregnancy.

What can a woman do to reduce her risk for abruption? In most cases, abruption cannot be prevented. However, a woman can help reduce her risk by: Keeping high blood pressure under control. Women who have high blood pressure should see their provider regularly and take medication, if recommended. Women who are not yet pregnant should see their provider for a preconception checkup to get their blood pressure under control right from the start. Not smoking cigarettes Not using cocaine Wearing a seat belt. This can help prevent trauma resulting

2. What is placenta previa?

Placenta previa is a low-lying placenta that covers part or all of the opening of the cervix. This position can block the babys exit from the uterus. As the cervix begins to thin and dilate (open up) in preparation for labor, blood vessels that connect the placenta to the uterus may tear and cause bleeding. During labor and birth, bleeding can be severe, which can be dangerous to mother and baby.

 How common is placenta previa? Placenta previa occurs in about 1 in 200 pregnancies. What are the symptoms of placenta previa? The most common symptom of placenta previa is painless uterine bleeding during the second half of pregnancy. Women who experience vaginal bleeding in pregnancy should contact their provider. How is placenta previa diagnosed?

An abdominal ultrasound usually can diagnose placenta previa and pinpoint the placentas location. In some cases, providers may use a vaginal ultrasound to confirm the diagnosis. If the provider suspects placenta previa, he may not do a vaginal examination with his gloved finger because it can cause heavy bleeding.

What causes placenta previa?

Cigarette smoking Cocaine use Age older than 35 years Second or later pregnancy Previous uterine surgery, including a c-section or a D&C (dilation and curettage). A D&C is a procedure in which the cervix is dilated (opened) and the uterus is emptied with suction or an instrument called a curette. Women often have a D&C after a miscarriage. Being pregnant with twins, triplets or more

 What is the risk of placenta previa happening again in another pregnancy? A woman who has had a placenta previa in a previous pregnancy has a 2- to 3-percent chance of having it in another pregnancy.

Can a woman reduce her risk for placenta previa?

There is no known way to prevent placenta previa. However, a woman may be able to reduce her risk by avoiding using cigarettes and cocaine. She also may be able to reduce her risk in future pregnancies by not having an elective c-section (one that is scheduled for convenience) unless there is a medical reason. Studies suggest that a womans risk of placenta previa increase with each cesarean birth.

3. What is placenta accreta?

Placenta accreta is a placenta that implants too deeply and too firmly into the uterine wall. Similarly, placenta increta and percreta are placentas that imbed themselves even more deeply into uterine muscle or through the entire thickness of the uterus, sometimes extending into nearby structures, such as the bladder. The abnormal implantation of the placenta is likely to occur at the site of a uterine scar from prior surgery or c-section.

 How common are placenta accreta and related disorders?

These disorders occur in up to 1 in 530 births. The rates of these conditions are increasing, largely due to the rising rate of c-sections. Placenta accreta and related disorders sometimes lead to premature birth.

What are the symptoms of placenta accreta and related disorders?

Like placenta previa, these disorders often cause vaginal bleeding in the third trimester.

Who is at risk for placenta accreta and related disorders?

These disorders occur most often in women who have placenta previa in the current pregnancy and who have had one or more c-sections or other uterine surgeries.

 How are placenta accreta and related disorders diagnosed? These disorders can be diagnosed with an abdominal or vaginal ultrasound. In some cases, another imaging technique called magnetic resonance imaging (MRI) may be recommended. How are placenta accreta and related disorders treated? When placenta accreta is diagnosed before birth, the provider may recommend a c-section immediately followed by a hysterectomy (surgical removal of the uterus). This approach appears to reduce blood loss and complications in the mother. The provider may recommend that the woman give birth at around 34 to 35 weeks of pregnancy to help prevent dangerous bleeding. If a woman wants to have future pregnancies, the provider may perform certain surgical

 What are some other placental problems? In some cases, the placenta does not develop correctly or function as well as it should. It may be too thin, too thick or have an extra lobe, or the umbilical cord may not be attached correctly. Problems can occur during pregnancy that damage the placenta, including infections, blood clots and infarcts, which is an area where tissue is destroyed. These placental abnormalities can contribute to a number of complications, such as: Miscarriage Poor fetal growth Premature birth Maternal bleeding at birth Birth defects

Umbilical cord abnormalities The umbilical cord is a narrow tube-like structure that connects the developing baby to the placenta. The cord is sometimes called the baby's supply line because it carries the baby's blood back and forth, between the baby and the placenta. It delivers nutrients and oxygen to the baby and removes the baby's waste products. The umbilical cord begins to form at 5weeks after conception. It becomes progressively longer until 28 weeks of pregnancy, reaching an average length of 22 to 24 inches. As the cord gets longer, it generally coils around itself. The cord contains three blood vessels: two arteries and one vein.

 What is single umbilical artery? About 1 percent of singleton and about 5 percent of multiple pregnancies (twins, triplets or more) have an umbilical cord that contains only two blood vessels, instead of the normal three. In these cases, one artery is missing. The cause of this abnormality, called single umbilical artery, is unknown. What is umbilical cord prolapse? Umbilical cord prolapse occurs when the cord slips into the vagina after the membranes (bag of waters) have ruptured, before the baby descends into the birth canal. This complication affects about 1 in 300 births. The baby can put pressure on the cord as he passes through the cervix and vagina during labor and delivery. Pressure on the cord reduces or cuts off blood flow from the placenta to the baby, decreasing the baby's oxygen supply. Umbilical cord prolapse can result in stillbirth unless the baby is delivered promptly, usually by cesarean section.

The risk of umbilical cord prolapse increases if: The baby is in a breech (foot-first) position. The woman is in preterm labor. The umbilical cord is too long. There is too much amniotic fluid. The provider ruptures the membranes to start or speed up labor. The woman is delivering twins vaginally. The second twin is more commonly affected.

What is vasa previa?

Vasa previa occurs when one or more blood vessels from the umbilical cord or placenta cross the cervix underneath the baby. The blood vessels, unprotected by the Wharton's jelly in the umbilical cord or the tissue in the placenta, sometimes tear when the cervix dilates or the membranes rupture. This can result in life-threatening bleeding in the baby. Even if the blood vessels do not tear, the baby may suffer from lack of oxygen due to pressure on the blood vessels. Vasa previa occurs in 1 in 2,500 births.

 What is a nuchal cord? About 25 percent of babies are born with a nuchal cord (the umbilical cord wrapped around the baby's neck). A nuchal cord, also called nuchal loops, rarely causes any problems. Babies with a nuchal cord are generally healthy. What are umbilical cord knots? About 1 percent of babies are born with one or more knots in the umbilical cord. Some knots form during delivery when a baby with a nuchal cord is pulled through the loop. Others form during pregnancy when the baby moves around. Knots occur most often when the umbilical cord is too long and in identicaltwin pregnancies. Identical twins share a single amniotic sac, and the babies' cords can become entangled.

What is an umbilical cord cyst? Umbilical cord cysts are outpockets in the cord. They are found in about 3 percent of pregnancies. There are true and false cysts: True cysts are lined with cells and generally contain remnants of early embryonic structures. False cysts are fluid-filled sacs that can be related to a swelling of the Wharton's jelly.