The Placenta. I've heard of a woman having problems with the placenta. What is the placenta? The placenta is a flat, spongy structure that grows inside the mother's uterus. It is attached to the fetus by the umbilical cord and carries nourishment and oxygen from the mother to the baby. It also carries waste products from the baby to the mother for excretion. The placenta produces hormones called HCG (human chorionic gonadotropin), estrogen and progesterone. Placenta Previa I have a friend who had placenta previa. What is it? With placenta previa, the placenta covers part or all of the cervix. Why is this a problem? When the cervix begins to open (dilate), the placenta is pulled away from the uterus, causing heavy bleeding. This can be dangerous for the mother-to-be and the baby. What are the signs and symptoms of placenta previa? The most characteristic symptom in placenta previa is painless bleeding. If I experience this painless bleeding, what will my doctor do? He or she will order an ultrasound exam to determine the location of the placenta. Your physician will not do a pelvic exam because it may cause heavier bleeding. If you see another doctor or when you go to the hospital, tell whomever examines you that you have placenta previa and should not have a pelvic exam.
Are there things I shouldn't do if I know I have placenta previa? Most physicians recommend avoiding intercourse, traveling and pelvic exams. If I have placenta previa, will I have to have a Cesarean section? The baby is more likely to be in a breech position. For this reason, and also to avoid bleeding, you will most likely have a C-section. How common is placenta previa? It occurs in about 1 birth in 200. Placenta! Abruption In an article about pregnancy problems, I read placental abruption can be very serious. What is it? Placenta! abruption is separation of the placenta from the wall of the uterus during pregnancy. Normally the placenta does not separate until after delivery of the baby. Is placental abruption dangerous? When the placenta separates before birth, it can be very serious for the baby. How often does it occur? The frequency of placental abruption is estimated to be about 1 in every 80 deliveries. What causes placental abruption? The cause of placental abruption is unknown; however, Certain conditions make it more likely to occur: - trauma to the mother, such as from a fall or a car accident
- an umbilical cord that is too short
- very sudden change in the size of the uterus, such as with the rupture of membranes
- hypertension
- dietary deficiency
- an abnormality of the uterus, such as a band of tissue in the uterus called a uterine septum
How will I know if I have placental abruption? Watch for the following signs and symptoms: - heavy bleeding from the vagina
- uterine tenderness
- uterine contractions
- premature labor
- lower-back pain
Placental abruption may occur without the presence of any or all of these symptoms. Are there any tests available to help diagnose placental abruption? Ultrasound may be helpful, but it does not always provide an exact diagnosis. What are the risks to the woman with placental abruption? Risks to the mother-to-be include shock, severe blood loss and the inability of the blood to clot. How is it treated? The most common treatment is delivery of the baby. However, the decision of when to deliver the baby depends on the severity of the problem. If I have placental abruption, does it mean I have to have a C-section? In some situations, if the baby needs to be delivered rapidly, you will need a Cesarean section. Each case must be handled on an individual basis. Can a woman do anything to prevent placental abruption? We now believe deficiency of folic acid may play a role in causing placental abruption. Extra folic acid may be prescribed during pregnancy. Maternal smoking and alcohol use may make it more likely for a woman to have placental abruption. If you smoke or drink alcohol, you will be advised to stop both activities. Retained Placenta I've heard about something called a retained placenta. What is this? One complication following the birth of a baby is a placenta that does not deliver following the birth, called a retained placenta. Usually the placenta separates on its own from the uterus a few minutes after delivery. In some cases, it doesn't separate because it is attached to the wall of the uterus. This can be very serious and can cause extreme blood loss. What causes a retained placenta? Some reasons for a retained placenta include a placenta attaching over a previous C section scar or other incision scar on the uterus in a place that has been curetted (scraped), such as with a D&C, or over an area of the uterus that was infected. What problems can a retained placenta cause? The most significant problem is heavy bleeding after delivery. If the placenta is not delivered, it must be removed some other way. One solution is to perform a D&C. However, if the placenta has grown into the wall of the uterus, it may be necessary to remove the uterus by performing a hysterectomy. Is a retained placenta common? No. It occurs in about 1 % of all deliveries.
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