Placental Complications

What is the placenta?

The placenta is a remarkable organ, albeit a temporary one, that attaches to the inside wall of your uterus during pregnancy. Placentas are disc-shaped, about 8 inches in diameter, and almost 1 inch thick. They’re mostly made up of blood vessels that serve to connect your body systems and your baby by way of the umbilical cord.

The placenta performs the following functions during pregnancy:

• Supplies your baby with nutrients and oxygen as your blood flows through the placenta
• Expels carbon dioxide and waste from your baby
• Transfers hormones that help your baby develop and grow
• Lends your immunity system by passing antibodies to your baby

Where does the placenta normally attach?

When the mass of cells that are becoming a baby implants in the uterine wall around week 4, some of these cells split away and begin forming the placenta. By week 12, the placenta takes over all baby-nurturing functions.

The placenta can attach anywhere to the wall of your uterus. The location is dictated by where the fertilized egg attaches to your uterus. These are the common locations:

• Posterior placenta. The placenta attaches to the back wall of your uterus (toward the spine). Posterior placentas are most common and considered “least likely to cause complications,” but they are associated with premature labor.
• Anterior placenta. The placenta attaches to the wall of your uterus that is closest to your abdomen. Since the placenta can move and grow during pregnancy, anterior placentas are at a slightly increased risk for placenta previa.
• Fundal placenta. The placenta attaches near the top.
• Lateral placenta. The placenta attaches to the right side or left side wall of your uterus.
• Low-Lying Placenta. The placenta attaches low in the uterus near or covering and blocking the cervix.

What is a fundal placenta, and what are the different types?

A fundal placenta is located near the top of the uterus between 2 fallopian tube openings called the fundus. The fertilized egg travels down a fallopian tube into the uterus, where it attaches to the uterus wall. The placenta develops where the egg attaches.

There are 2 different types of fundal placenta:

• An anterior fundal placenta forms at the top and continues down the uterus wall to the front of the uterus (near the belly).
• A posterior fundal placenta forms at the top and continues down the uterus wall to the back of the uterus (near the spine).

Is it better to have a fundal posterior or anterior placenta?

As far as a preference, the 2 locations fulfill their functions equally well. However, a posterior placenta is better in the sense that, with the placenta on the back wall, the mother can feel the baby’s movements and kicks earlier in the pregnancy.

Also, the position of the placenta will determine which way your baby is facing. With a posterior placenta, the baby will face your spine and allow their growth to more easily line up in the birth canal for a vaginal birth.

Is it okay for the placenta to be on top?

It does not pose any significant problems if a placenta is attached at the top of the uterus. Like any placenta, regardless of its location, it must be monitored to ensure that it’s functioning properly.

Is a fundal posterior placenta normal?

A posterior fundal placenta is normal and quite common. In some ways, it’s considered the preferred location for your placenta.

Can a placenta move during pregnancy?

The placenta gives an appearance of moving because the placenta expands along with the uterus as it increases in size to accommodate the growing baby. The placenta can expand up until about 32 weeks of pregnancy. Usually, the expansion and movement are away from the cervix.

Variations in the location of the placenta are natural, and it’s still able to do its job—most of the time. Doctors cannot change the location of a placenta or treat it, so placenta risks cannot be fixed, only monitored.

What causes placental complications during pregnancy?

These factors can increase the risk of placental complications:

Common placenta complications

To be clear—placental complications are not common. Placenta previa, for example, occurs in about 1 in 200 pregnancies, and most of the time it can be monitored for a successful outcome. However, doctors and medical providers need to be vigilant in checking a baby’s health throughout pregnancy and be ready to act if the baby is in distress (not getting enough oxygen or nutrients).

Below are the most common placenta complications:

• Placenta accreta. When part or the entire placenta is too deeply implanted in the uterus wall and cannot be removed. It’s a potentially life-threatening condition that causes uncontrollable bleeding after birth. Placenta accreta often forms over uterine scars, and it’s on the rise in the United States (1 in every 533 pregnancies) because more women are having C-sections—and multiple C-sections greatly increase the risk. It can be diagnosed by ultrasound and MRI. A whole medical team is necessary to successfully deliver the baby via planned C-section and keep the mother from losing too much blood. Risks for a mother with placenta accreta include massive blood loss, hysterectomy and death.
• Placenta previa. When the placenta partially or completely blocks the entrance to the birth canal (cervix opening). Also known as a “low-lying placenta,” placenta previa affects only 1 in 200. During labor, the cervix dilates, and blood vessels in a placenta previa can tear and bleed heavily. Also, if the placenta is completely blocking the baby’s way out, the baby cannot be delivered vaginally. C-sections are recommended for all cases of placenta previa to prevent fetal distress and maternal bleeding.
• Placental abruption. When the placenta detaches partially or completely from the uterus wall before the birthing process. Placentas normally detach in the last stage of labor and are delivered as afterbirth. Mild abruption, if properly monitored, may not affect your baby, but complete abruption can cause serious bleeding in the uterus, and it also severs the baby’s supply of oxygen and nutrients. This can cause growth problems, premature birth, severe birth injury or death. Severe placental abruption is considered an emergency, and the baby must be delivered right away.
• Retained placenta. When a portion of the placental tissue remains inside the mother’s uterus for 30 minutes or more after birth. This situation can occur either in cases of placenta accreta or during a typical childbirth when the uterus fails to contract adequately. The presence of retained placental tissue can result in severe bleeding or infection, posing a significant risk to the mother’s life. Immediate action is necessary to prevent further complications, and methods such as manual removal, administration of medications, or surgical procedures may be employed to address the issue promptly.
• Malformation of the placenta. When the placenta may not have developed correctly. It can be too thin, too thick, have an extra lobe, or have extra membranes. Usually, a malformed placenta is associated with decreased blood flow to the baby and greater chances of the mother bleeding out or being infected during childbirth. Medical providers need to carefully screen for any placental problems during pregnancy and treat any symptoms to keep the mother and baby healthy.

Protecting mothers and babies

Some dangers cannot be prevented. Others can.

Ultrasound can pick up most placenta problems. As early as 8 weeks, the placenta can be seen on abdominal scans. Most placental problems develop in the third trimester, so the good news is there’s usually plenty of time to keep you and your baby safe. Proper medical monitoring can save lives—but negligent monitoring or treatment can turn a placental problem into birth injury or death.

Contact an experienced birth injury lawyer

Birth injuries can lead to serious health consequences that require costly, life-long treatment and rehabilitation. If you believe your child suffered a birth injury because of a doctor’s medical negligence, you owe it to yourself and your child to get the compensation they need to live their life to the fullest.

If you have questions about the birth injury lawsuit process or want help filing your claim, contact attorney Laura Brown at Brown Trial Firm. Laura has years of experience in birth injury law, helping families like yours all across the U.S. get the compensation they deserve.

Contact her today for a free consultation of your case.