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
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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.
More about Dr. Rad
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.
Call us at (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.
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
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.
