Though rare, placental complications can cause serious bleeding that can put mother and baby at high risk. Almost 4% of pregnancy complications include a placental condition.
Placental complications are serious problems. They can cause difficulties for the pregnant person and their baby, especially during delivery.
But with close supervision from high-risk pregnancy specialists, these gestation worries can be effectively managed. Pregnant women in the Los Angeles area seek the expert counsel of Dr. Steve Rad, a double-board certified Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine (MFM).
Dr. Rad specializes in high-risk pregnancies and advises expectant mothers to remain vigilant about their conditions. Low-risk pregnancies can quickly escalate to high-risk.
Dr. Rad and his team at the Los Angeles Fetal and Maternal Care Center have decades of perinatology experience. They are among the very best high-risk pregnancy specialists in Los Angeles and are dedicated to ensuring healthy pregnancy outcomes.The team is also available to provide second opinions.
What is the placenta?
The placenta is an organ that develops in the uterus during pregnancy. It provides nutrients and oxygen to your baby and removes waste from your baby’s blood. The placenta is attached to the uterus and connects to the baby’s umbilical cord.
Pregnancy issues with the placenta
Placenta previa
When the placenta connects to the wall of the uterus ower than normal it is called placenta previa. This serious condition — where the placenta partially or completely covers the cervix — affects 1 in 200 women, usually during the third trimester
Placenta previa can cause vaginal bleeding both before and during birth. This blood loss can be severe and may need immediate intensive care.
Most women suffering from this condition need to deliver by Cesarean section.
Types of placenta previa
Marginal – The placenta extends to the edge of the cervix
Partial – The placenta partially covers the cervix
Complete – The placenta fully covers the cervix
Placenta previa complications
In addition to bleeding, placenta previa may cause other complications, including:
Preterm birth
Cramps
Fetal infection
Tear in the placenta
Placenta previa risk factors
The following women are most at-risk:
Over 35 years of age
Smokers
Have had a C-section or uterine surgery
Women carrying multiple fetuses (twins, triplets, etc.)
Placental abruption
Placental abruption is a medical emergency during which the placenta separates from the uterine wall before the baby is delivered.
Occurring in 1% of pregnancies, placental abruption is the leading cause of premature delivery and newborn mortality, as well as fetal growth restriction (FGR).
Complications from placental abruption
Because the placenta plays a major role in providing oxygen and nutrients to the baby, placental abruption can lead to abnormal fetal development, fetal growth restriction, and stillbirth.
Mothers may suffer from vaginal bleeding, intrauterine or abdominal pain, continuous contractions, and fetal heart abnormalities.
Placental abruption risk factors
Abdominal trauma
Preterm membrane rupture
Smoking by either parent
Use of cocaine or alcohol
Prior placental abruption
Having placenta previa
Uterine defects
High blood pressure
Circumvallate placenta
Previous cesarian section
Multiple fetuses
Abnormal fetal heart rate
Call (844) 473-6100 or click here to schedule online
What is placental insufficiency?
In this condition, which occurs in 1 in 300 pregnancies, the placenta does not function correctly. As a result, the fetus is deprived of blood flow and nutrients and has restricted growth or low birth weight.
Patients with this condition may notice less fetal movement and smaller uterus size.
There is no cure for placental insufficiency, but it is vital to receive follow-up and prenatal care from your high-risk OB.
Symptoms of placental insufficiency include placental abruption, preterm labor and delivery, and pre-eclampsia.
Placental insufficiency risk factors
Pre-eclampsia
Diabetes
Smoking or illicit drugs
Blood clotting issues
Almost 4% of pregnancy complications include a placental condition.
Placenta accreta, placenta increta, and placenta percreta
These three conditions are similar but differ in their severity. All involve the placenta attaching too deeply to the uterine wall.
Placenta accreta – the placenta attaches too deeply to the uterine wall
Placenta increta – the placenta becomes embedded in the uterus’ muscle wall
Placenta percreta – the placenta grows through the uterus and potentially into nearby organs
The major consequences of these three conditions are that the placenta cannot come out after the baby is delivered and attempts to remove it result in heavy bleeding.
Using ultrasound, the perinatologist can make an accurate diagnosis before delivery. With a high-risk OB, these complications and risks can typically be managed.
Retained placenta complications
A natural part of the birthing process is for the placenta to follow the baby out of the womb. If the placenta is not expelled, it can be life-threatening to the mother.
There are three methods used for removing the retained placenta from the womb:
The doctor can remove it manually, but this has a risk of infection.
Medicine that relaxes the uterus can push the placenta out.
Breastfeeding causes the uterus to contract and expel the placenta.
Vasa previa
When fetal blood vessels from the placenta or umbilical cord cross the entrance to the birth canal below the baby it is called vasa previa.
This rare condition (1 in every 2,500 births) can cause a rapid fetal hemorrhage or lack of oxygen. Often, vasa previa is asymptomatic during the first trimester but can also present with sudden heavy bleeding in the second or third trimester.
A blood test is used for rapid identification of this condition, enabling timely intervention by high-risk pregnancy specialists.
When diagnosed by a high-risk OB, the outlook of vasa previa is favorable. The fetal mortality rate is quite low when a C-section is performed after the baby’s lungs are developed.
Circumvallate placenta
Occurring in about 1-2% of pregnancies, circumvallate placenta occurs when the placenta doubles back on itself during development. The curve in the fetal side of the placenta decreases the flow of blood and nutrients to the developing baby.
Circumvallate placenta results in slowed growth of the fetus and may cause placental abruption, decreased amniotic fluid level, miscarriage, or preterm birth. It can often be diagnosed or confirmed with an ultrasound.
There is no direct way to treat circumvallate placenta, but we can take steps to reduce the risk of complications. You’ll need extra growth checks and ultrasounds to monitor your baby’s development. If the fetus is not growing fast enough, early delivery or an emergency C-section may be necessary.
Meet Dr. Rad: Exceptional Maternal-Fetal Medicine Care
Perinatologist Dr. Rad and his world-class Maternal-Fetal Medicine (MFM) obstetrics and gynecology team at Los Angeles Fetal and Maternal Care understand your High-Risk OB and infertility needs before, during, and after birth. We provide compassionate care and help you understand your pregnancy, answer questions, and provide emotional support to safely navigate your pregnancy.
Dr. Rad has undergone rigorous training with high honors at renowned institutions including the Department of Obstetrics and Gynecology at David Geffen School of Medicine at UCLA, USC, Cedars-Sinai Medical Center, and UCSF Medical Center, as well as centers internationally in London, Austria, Israel, and Africa.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.
Call (844) 473-6100 or click here to schedule online
Placental conditions FAQs
What causes placental insufficiency?
Placental insufficiency, a condition where the placenta doesn’t function properly, can be caused by various factors. These include conditions such as high blood pressure, diabetes, autoimmune disorders, blood clotting disorders, and certain infections. Lifestyle factors such as smoking, drug use, and poor nutrition can also contribute to placental insufficiency. Additionally, maternal age, multiple pregnancies (such as twins or triplets), and certain genetic factors may increase the risk. Placental insufficiency can result in inadequate oxygen and nutrients reaching the fetus, leading to growth restriction, preterm birth, or other complications.
What causes placental abruption?
Placental abruption occurs when the placenta partially or completely separates from the uterine wall before delivery, which can lead to significant bleeding and other potential complications. The exact cause of placental abruption is not always clear, but it is often associated with high blood pressure, trauma to the abdomen, rapid uterine decompression, or certain risk factors like smoking, drug use, advanced maternal age, or previous incidences of placental abruption. These factors can disrupt the normal blood flow to the placenta, leading to its detachment from the uterine wall.
What is posterior placenta?
The posterior placenta refers to the placement of the placenta on the back wall of the uterus, towards the mother’s spine. Placental location can vary among pregnancies and can have implications for fetal development and maternal health. When the placenta is posterior, it typically doesn’t pose any significant risks on its own, but its position can affect the sensations a mother may feel during fetal movement. Additionally, the position of the placenta may influence the ease of visualization during ultrasound scans.
What is anterior placenta?
An anterior placenta refers to the placement of the placenta on the front wall of the uterus, closest to the mother’s abdomen. Like the posterior placenta, the location of the placenta can vary among pregnancies. Having an anterior placenta may impact a woman’s experience of feeling fetal movements.
Additionally, during ultrasound examinations, the anterior placenta may sometimes partially obstruct the view of the fetus, requiring the sonographer to adjust the scanning technique to obtain clear images.
What is battledore placenta?
A battledore placenta, also known as marginal cord insertion, is a rare variation in which the umbilical cord attaches to the edge or margin of the placenta instead of the center. This condition is typically considered benign and doesn’t usually cause significant problems during pregnancy. However, in some cases, a battledore placenta may be associated with an increased risk of complications such as restricted fetal growth or placental abruption, particularly if the cord insertion is very close to the placental edge.
Can circumvallate placenta go away?
Circumvallate placenta is a rare condition where the fetal membranes fold back upon themselves near the edge of the placenta, creating a raised ring-like structure. This condition is typically diagnosed during pregnancy through ultrasound examinations. Unlike other placental variations, circumvallate placenta does not resolve during pregnancy. It remains present throughout the duration of the pregnancy. While circumvallate placenta itself may not cause significant problems, it has been associated with an increased risk of complications such as placental abruption, preterm birth, and fetal growth restriction.
What causes low lying placenta?
A low-lying placenta, also known as placenta previa, occurs when the placenta implants low in the uterus, near or covering the cervix.
While most cases of low-lying placenta detected early in pregnancy may resolve on their own as the uterus grows and expands, some may persist and require close monitoring throughout pregnancy due to the risk of vaginal bleeding, preterm birth, or other complications.
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Fetal outcomes can be worse with conditions related to placental complications, depending on the severity. Issues like abnormal fetal development, growth restriction, stillbirth, and preterm birth can result. The impact varies based on the specific complication and individual circumstances.
What prenatal screenings detect this issue?
Prenatal screenings for placental complications may include ultrasounds, fetal echocardiograms, and tests like chorionic villus sampling and amniocentesis. These screenings can help in the early detection and management of placental issues during pregnancy.
Can this lead to abnormal fetal growth?
Placental insufficiency can lead to abnormal fetal growth due to inadequate oxygen and nutrients reaching the fetus. This condition, caused by various factors like high blood pressure and diabetes, can result in growth restriction, preterm birth, and other complications for the baby.
Do certain pregnancies have higher risks?
Yes, certain pregnancies, such as those in women over 35, smokers, multiple fetus pregnancies, and those with placental complications, have higher risks of complications like placental abruption, preterm birth, and fetal growth restriction. These women may need specialized care to manage and mitigate these risks effectively.
Are there specific maternal complications?
Maternal complications, such as placental abruption, preterm labor, and preeclampsia, are associated with placental issues like placental insufficiency or placenta previa. These complications can lead to serious outcomes for both the mother and the baby, requiring expert guidance from specialists like Dr. Steve Rad.
Does this affect fetal survival rates?
Placental complications like placental abruption can significantly impact fetal survival rates by leading to abnormal fetal development, growth restriction, and stillbirth. Inadequate oxygen and nutrient supply to the fetus can result in complications that affect survival during and after birth.
Can early ultrasounds identify this?
An early ultrasound can help identify placental complications such as placenta previa, low-lying placenta, or a battledore placenta. Early detection allows for monitoring and appropriate management to ensure the best possible outcome for mother and baby.
Does this condition necessitate cesarean delivery?
In cases of Placenta Previa, doctors may recommend a C-section for the delivery to avoid potential risks associated with vaginal birth due to the placenta's low placement in the uterus. The decision is made based on individual circumstances for the safety of both mother and baby.
Are there tell-tale ultrasound markers?
In ultrasound scans, tell-tale markers like marginal cord insertion, circumvallate placenta, and low-lying placenta can indicate potential placental complications. These markers may require monitoring for potential risks throughout pregnancy.
Can maternal age influence its occurrence?
Maternal age can influence the occurrence of placental complications. Women over 35 are at higher risk, along with smokers and those who have had previous C-sections or uterine surgeries. Additionally, carrying multiple fetuses increases the likelihood of experiencing placental issues during pregnancy.
Does this impact umbilical cord function?
While placental conditions can impact fetal development and pregnancy outcomes, their direct effect on umbilical cord function can vary. Depending on the specific placental complication, there may be implications for the umbilical cord's ability to facilitate oxygen and nutrient exchange between mother and fetus. It is essential to monitor these conditions closely to assess any potential impact on overall fetal health and well-being.
Are intervention strategies commonly required?
Intervention strategies for placental complications may be necessary in severe cases to prevent serious risks to the mother and baby. These strategies can include close monitoring, medication, bed rest, or surgical interventions depending on the specific complication and its severity. Each situation is unique and requires individualized care.
Is there a genetic predisposition factor?
Genetic predisposition factors can contribute to placental complications. High-risk individuals may have a genetic predisposition for conditions like placenta previa, placental abruption, or placental insufficiency, making it crucial for informed consultations to assess and manage potential risks. Understanding genetic predispositions can help tailor care plans for optimal outcomes.
Can this increase miscarriage risks?
An anterior placenta placement, a potentially normal variation, isn't directly linked to miscarriage risks. Its position may impact fetal movement perception but generally doesn't pose a direct threat in this regard. Misplacement could lead to minor issues but typically not augmented miscarriage risks.
Are associated risks higher in twins?
In twin pregnancies, the risks are typically higher due to factors such as preterm birth, low birth weight, and possible complications associated with sharing a placenta. Monitoring and managing these risks effectively is crucial for the health and well-being of both mother and babies in twin pregnancies.
Does this affect fetal weight significantly?
Placental insufficiency can significantly impact fetal weight. Insufficient oxygen and nutrients reaching the fetus due to this condition can lead to growth restriction, preterm birth, and other complications, affecting the overall weight and development of the baby.
Are specific treatments available for this?
Yes, specific treatments are available for various placental complications, depending on the specific condition. Treatment options may include close monitoring, medications, bed rest, vaginal or cesarean delivery, or other interventions tailored to each patient's individual situation. Consulting with a specialist is crucial to determine the most appropriate course of action for each unique case.
Can this lead to placental abruption?
Yes, placental insufficiency can lead to placental abruption. Impaired placental function can result in complications such as abnormal fetal development, fetal growth restriction, and stillbirth, all of which can potentially lead to placental abruption.
Are pregnancy outcomes generally favorable?
Yes, pregnancy outcomes are typically favorable with proper care from Dr. Rad's experienced team, leading to healthy pregnancies and successful deliveries. Monitoring and addressing placental complications help ensure positive outcomes for both mother and baby.
Is this linked to preeclampsia development?
In some cases, placental insufficiency can lead to preeclampsia development due to the inadequate oxygen and nutrient supply to the fetus, potentially triggering complications that may contribute to the onset of preeclampsia during pregnancy.
Are there common signs during pregnancy?
Common signs during pregnancy may include morning sickness, fatigue, breast tenderness, and frequent urination. Additionally, mood swings, food aversions/cravings, and heightened sense of smell are often experienced. It's crucial to consult a healthcare provider for proper evaluation and guidance during pregnancy.
Can this precipitate early labor onset?
Placental complications like placental abruption can lead to early labor onset due to potential disruptions in fetal oxygen and nutrient supply. The condition may trigger contractions, putting the mother and baby at risk for premature delivery. Monitoring and prompt medical intervention are crucial in such cases.
Is recurrence in subsequent pregnancies likely?
Recurrence in subsequent pregnancies with placental complications is possible but not guaranteed. Risk factors, maternal health, and individual circumstances play a role. Discuss with a specialized obstetrician for personalized guidance.
Does this alter normal placental development?
A battledore placenta, also called marginal cord insertion, is a rare anomaly where the umbilical cord attaches to the edge, not the center. It can increase risks like fetal growth restriction or placental abruption, affecting normal placental development but not always altering it.
Are any preventative measures effective?
Incorporating lifestyle changes, such as quitting smoking and maintaining a healthy diet, can potentially reduce the risk of placental complications. Regular prenatal care, avoiding high-risk activities, and following medical advice are crucial preventive measures.
How frequently does this occur worldwide?
Placental complications like placental abruption, placental insufficiency, and placenta previa occur worldwide, albeit at varying frequencies, with estimates showing prevalence in a range of percentages depending on the specific condition. These complications require specialized care and monitoring to ensure the health and safety of both mother and baby during pregnancy.
Does this influence maternal health postpartum?
Maternal health postpartum can be influenced by various factors, including the mother's physical recovery from labor and delivery, emotional well-being, and the level of support she receives. It's essential to consider these aspects to ensure a smooth transition to postpartum life and monitor for any potential complications that may arise.
What follow-up care is recommended after?
After placental complications, follow-up care may include monitoring for bleeding, preterm labor, fetal growth abnormalities, and complications like placental insufficiency or abruption. Consult with a specialist for personalized guidance and support throughout the pregnancy and postpartum period.
Are there established management guidelines?
Management guidelines for placental complications involve close monitoring, timely intervention, and individualized care plans tailored to each patient's specific needs. Treatment strategies are guided by the type and severity of the placental issue, with the aim of ensuring the best possible outcomes for both mother and baby. Consultation with a specialist like Dr. Rad can provide personalized guidance based on the unique circumstances of each case.
Is the diagnosis clear on routine scans?
The clarity of the diagnosis on routine scans can vary based on the specific placental complication being assessed. Factors such as the positioning of the placenta, fetal movements, and other maternal conditions can influence diagnostic certainty. Close monitoring and further imaging may be necessary for a definitive diagnosis.
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