Placenta: How it works, what's normal
Placenta: How it works, what's normal
Placenta — Understand the conditions that can affect the placenta during pregnancy.
If you're pregnant, you might wonder what the placenta does and what factors can affect the placenta. Get the facts about this important fetal organ.
What does the placenta do?
The placenta is an organ that develops in your uterus during pregnancy. This structure provides oxygen and nutrients to your growing baby and removes waste products from your baby's blood. The placenta attaches to the wall of your uterus, and your baby's umbilical cord arises from it. In most pregnancies, the placenta attaches at the top or side of the uterus.
What affects placental health?
Various factors can affect the health of the placenta during pregnancy, some modifiable and some not. For example:
- Maternal age. Certain placental problems are more common in older women, especially after age 40.
- Premature rupture of the membranes. During pregnancy, your baby is surrounded and cushioned by a fluid-filled membrane called the amniotic sac. If the sac leaks or breaks before labor begins, the risk of certain placental problems increases.
- High blood pressure. High blood pressure can affect your placenta.
- Twin or other multiple pregnancy. If you're pregnant with more than one baby, you might be at increased risk of certain placental problems.
- Blood-clotting disorders. Any condition that either impairs your blood's ability to clot or increases its likelihood of clotting increases the risk of certain placental problems.
- Previous uterine surgery. If you've had a previous surgery on your uterus, such as a C-section or surgery to remove fibroids, you're at increased risk of certain placental problems.
- Previous placental problems. If you've had a placental problem during a previous pregnancy, you might be at increased risk of experiencing it again.
- Substance abuse. Certain placental problems are more common in women who smoke or use illegal drugs, such as cocaine, during pregnancy.
- Abdominal trauma. Trauma to your abdomen — such as from a fall or other type of blow to the abdomen — increases the risk of certain placental problems.
What are the most common placental problems?
During pregnancy, the most common placental problems include placental abruption, placenta previa and placenta accreta. These conditions can cause potentially heavy vaginal bleeding. After delivery, retained placenta is also sometimes a concern.
- Placental abruption (abruptio placentae). If the placenta peels away from the inner wall of the uterus before delivery — either partially or completely — it's known as placental abruption. Placental abruption can cause varying degrees of vaginal bleeding and pain or cramping. It might also deprive the baby of oxygen and nutrients. In some cases, early delivery is needed.
- Placenta previa. This condition occurs when the placenta partially or totally covers the cervix — the outlet for the uterus. Placenta previa is more common early in pregnancy and might resolve as the uterus grows. Placenta previa can cause severe vaginal bleeding before or during delivery. A C-section delivery usually is required if the placenta previa is present at the time of delivery.
- Placenta accreta. This condition occurs when the blood vessels of the placenta grow too deeply into the uterine wall. Placenta accreta can cause vaginal bleeding during the third trimester of pregnancy and severe blood loss after delivery. Treatment might require a C-section delivery followed by surgical removal of the uterus (abdominal hysterectomy). More-aggressive forms of this problem can also occur if the placenta invades the muscles of the uterus (placenta increta) or if the placenta grows through the uterine wall (placenta percreta).
- Retained placenta. If the placenta isn't delivered within 30 to 60 minutes after childbirth, it's known as retained placenta. Retained placenta might occur because the placenta becomes trapped behind a partially closed cervix or because the placenta is still attached to the uterine wall — either loosely (adherent placenta) or deeply (placenta accreta). Left untreated, a retained placenta can cause severe infection or life-threatening blood loss in the mother.
What are signs or symptoms of placental problems?
Consult your health care provider during pregnancy if you have:
- Vaginal bleeding
- Abdominal pain
- Severe back pain
- Rapid uterine contractions
- A fall, car accident or other trauma to your abdomen
What can I do to reduce my risk of placental problems?
Most placental problems can't be directly prevented. However, you can take steps to promote a healthy pregnancy. For example:
- Visit your health care provider regularly throughout your pregnancy
- Work with your health care provider to manage any health conditions, such as high blood pressure
- Don't smoke or use illegal drugs
- Talk with your doctor before deciding to pursue an elective C-section
If you've had a placental problem during a previous pregnancy and are planning another pregnancy, talk to your health care provider about ways to reduce the risk of experiencing the condition again. Tell your health care provider if you've had surgery on your uterus in the past. Expect your health care provider to carefully monitor your condition throughout the pregnancy.
How is the placenta delivered?
If you deliver your baby vaginally, you'll also deliver the placenta vaginally — during what's known as the third stage of labor. After you give birth, you'll continue to have mild contractions. Your health care provider might massage your lower abdomen to encourage your uterus to contract and expel the placenta. You might be asked to push one more time to deliver the placenta, which usually comes out with a small gush of blood. The placenta is typically delivered in about five minutes. In some cases, it might take up to 30 minutes. If you have a C-section, your health care provider will remove the placenta from your uterus during the procedure.
Your health care provider will examine the placenta to make sure it's intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. If you're interested, ask to see the placenta. In some cultures, families bury the placenta in a special place, such as their backyards. Some women cook and eat the placenta, a practice known as human placentophagy.
If you have questions about the placenta or placental problems during pregnancy, talk to your health care provider. He or she can help you better understand the placenta's role.