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Placental Disorders (Abnormalities)

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Placental abnormalities
The placenta is a highly complex fetomaternal organ that connects the fetus through the umbilical cord to the mother. The functions of the placenta are to provide oxygen and nutrients to the developing fetus and consequently remove waste products from the fetus. The roles played by the placenta are vital and cannot be over emphasized. The placenta also functions as an endocrine gland, producing hormones and also protects the fetus against bacteria and other infections. The placenta is the life line of the fetus, for the placenta serves as the machinery through which the fetus is kept SAFE.

However, rarely, certain placental disorders or abnormalities can or may occur in some pregnancies. While the causes of these abnormalities are not fully understood, certain factors and/ or conditions have been implicated.

Risk factors

Many factors can cause or influence the health of the placenta during pregnancy; some are modifiable, while others are not. Some examples of such factors are:
  1. Maternal age: maternal age is one factor of placental abnormalities. Women over the ages of 40 may be at higher risk of developing placental disorders compared to those below age 40.
  2. High blood pressure (HBP): high blood pressure is another factor that can cause placental abnormalities.
  3. Cigarette smoking and substance abuse: women who smokes or use illicit (or illegal drugs) are also at higher risk of developing placental abnormalities, they are prone to experience such complications as placental disorder during pregnancy.
  4. Abdominal trauma: some level of trauma to the abdomen such as a fall or blow to the abdomen during pregnancy can cause placental disorders.
  5. Blood clotting disorder: maternal blood clotting disorder may also increase the risk of developing placental abnormalities.
  6. Uterine surgery: a history of surgery, maybe C-section from previous delivery may increase the risk of experiencing placental abnormalities.
  7. Multiple pregnancies: a pregnancy of twin or more may be at risk of placental disorders.
  8. Diabetes: a pregnant mother with a diabetic condition may also be at a high risk of developing placental problems.
  9. Previous placental disorders: having had a previous placental abnormality is enough to have an increased chances of developing another placental disorder.

Placental disorders

A placental disorder is any disease, disorder, dysfunction or abnormalities that  may affect the placenta during pregnancy There are different types of placental abnormalities that may arise, these conditions can cause heavy vaginal bleeding, abdominal pain, uterine tenderness, etc. Some of the most common placental disorders are:

Placenta previa

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Placenta previa
This is a very rare placental disorder in which the placenta is abnormally attached or situated at the bottom part of the uterus next to/ or over the cervix. In doing so, the placenta partially or completely covers the cervix. This type of placental abnormality can result in vaginal bleeding with no pain, either in late pregnancy or during labour. Sometimes, the bleeding can be very severe. Placenta previa is more common in early pregnancies and may resolve as the uterus grow. However, some do not resolve and eventually results in the placental condition.

Placenta previa can cause such pregnancy complications as;
  • Mild to severe vaginal bleeding,
  • Increased risk of fetal infection,
  • Placental tear,
  • Premature contractions and cramps,
  • Preterm labour, etc.
Most often, pregnancies with placenta previa requires Caesarean section (C-section) for delivery. Basically, there are two types of placenta previa, which are;

  1. Marginal placenta previa: this is a condition where the placenta covers the cervix partially.
  2. Complete placenta previa: this is a condition where the placenta totally or completely covers the cervix.

Abruptio placentae (placental abruption)

This is the partial or complete separation of the placenta from the uterine wall during pregnancy. This condition separates the fetus from the mother's blood supply thereby depriving the fetus (baby) from oxygen and nutrients causing growth restrictions and premature delivery and even fetal death.

Placental abruption is known to cause;
  • Severe vaginal bleeding,
  • Preterm contractions,
  • Abdominal pains, etc.
However, the symptoms seen or experienced depend on the severity of the placental separation and on the amount of blood loss. This condition normally occur during the late trimester, in most cases a C-section is required for delivery.
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Placenta accreta


Placenta accreta, increta and percreta

Normally, the placenta grows as the uterus grows and it supplies the baby with food and oxygen through the umbilical cord. The placenta attaches itself to the superficial layer of the upper part of the uterus. The placenta remains attached to the uterine wall until the baby is delivered. During the final stages of labour, the placenta separates from the uterus and is delivered through the birth canal as after birth (see figure below).

However, in some instances the placenta attaches too deeply to the uterine wall than it should. Now, depending on the depth of its attachment, it may results in either 1 of 3 types placental abnormalities. These abnormalities are placenta accreta, increta or percreta. Research shows that, these rare placental conditions occur in about 1 in 2500 pregnancies.

Placenta accreta: this placental condition occurs when the blood vessels of the placenta grows or are attached too deeply and firmly into the walls of the uterus.

Placenta increta: in this placental condition, the placenta attaches itself even more deeply and firmly through the uterine wall into the muscle of the uterus.

Placenta percreta: in this placental disorder, the placenta grows and pushes itself through the walls of the uterus and attaches to the surrounding organs such as the urinary bladder.



These placental conditions, accreta, increta and percreta can cause severe vaginal bleeding and blood loss after childbirth. In these instances, surgical intervention such as C-section maybe required for delivery. In more severe cases, a hysterectomy (surgical removal of the uterus) may be the only cause of action to protect the mother and the baby.

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