Placental Complications During Pregnancy

The placenta is an organ that grows in the uterus during pregnancy. It provides nutrients and oxygen to the baby and removes waste from the baby’s blood. Unfortunately, placental complications can occur that can impact both mom and her baby’s health. Medical staff must monitor the pregnancy and respond appropriately to any placental complications to avoid causing injury.

Did you have placental complications during your pregnancy?

If you or your baby were injured from medical malpractice, you may have a legal case.

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Some mothers may understandably feel very anxious to hear that they have an issue with their placenta. Being armed with the proper knowledge can help you make informed decisions with your medical team.

Common Placental Complications During Pregnancy

Placental complications can involve the placenta’s growth, function, or its attachment to the uterus. The most common placental issues that can happen during pregnancy are:

Placenta Previa

Placenta previa is a condition in which the placenta lies unusually low in the uterus. There are two types of placenta previa:

Marginal or partial previa: partially covers the mother’s cervix
Complete or total previa: completely covers the mother’s cervix and may block the baby’s passage out of the womb

According to the Cleveland Clinic, placenta previa may happen in 1 in 200 pregnancies. When doctors identify it early in pregnancy, placenta previa may not be a serious problem. As the baby grows, the placenta expands and lifts up and away from the cervix on its own.

Unfortunately, placenta previa is not always caught early on, or may lead to complications. Complications from placenta previa include:

Life-threatening hemorrhagic bleeding for the mother and baby
A tear in the placenta
Premature birth
Vaginal bleeding in the third trimester
Increased risk of fetal infection
Birth injuries such as hypoxic-ischemic encephalopathy (HIE)

Women may be at greater risk of developing placenta previa if they:

Have a history of cesarean delivery, uterine surgery, or abortion
Experience vaginal bleeding: The main symptom of placenta previa is vaginal bleeding. It is important that any vaginal bleeding be reported to your OB/GYN immediately.
Are over 35
Are carrying multiples
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Placenta previa can cause maternal or fetal bleeding requiring transfusions and result in HIE. Management includes early delivery before 40 weeks and having blood immediately available for transfusion.

Placental Abruption

Placental abruption happens when the placenta separates from the uterus. Placental abruption happens in about 1 out of every 100 pregnancies, according to the March of Dimes. It usually occurs in the third trimester, but can occur anytime after the 20th week of pregnancy. Placental abruption can lead to:

Fetal growth restriction (when the fetus grows too slowly in the womb)
Abnormal fetal development
Premature delivery
Stillbirth

Women may be at greater risk of developing placenta abruption if they:

Have a history of C-section delivery, uterine surgery, or abortion
Have had trauma to the abdomen
Have a history of a prior placental abruption
Have a circumvallate placenta
Have hypertension
Have preeclampsia
Have had a premature membrane rupture
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Are carrying multiples

Symptoms of placental abruption include:

Abdominal pain
Rapid contractions
Vaginal bleeding
Uterine tenderness
Fetal heart rate abnormalities
No symptoms at all early on

The main symptom of placental abruption is vaginal bleeding although vaginal bleeding may be hidden 20% of the time. The amount of bleeding and its persistence can vary. Report any vaginal bleeding to your physician immediately.

Management requires emergency delivery for placental abruption where a baby is not getting enough oxygen.

Placenta Accreta, Increta, and Percreta

In a normal pregnancy, the placenta is attached to the wall of the uterus until birth. Once the baby is delivered, the placenta then naturally separates from the uterine wall and leaves the body through the birth canal. Placenta accreta occurs when the blood vessels and other parts of the placenta have grown too deeply into the uterine wall, and the placenta is unable to detach properly. This complicates the natural separation of the placenta from the uterine wall.

Placenta increta is a similar, but more rare placental complication, which occurs when the placenta is attached deeper into the uterine wall and into the actual uterine muscle. Even rarer is placenta percreta, in which the placenta fully penetrates the uterus and attaches to another organ in the body. All of these conditions can lead to:

Vaginal bleeding in the third trimester
C-section delivery
Severe postpartum hemorrhage
Hysterectomy

Women who have had C-section deliveries or placenta previa in the past are said to have a higher chance of acquiring placenta accreta. According to the American Pregnancy Association, 1 in 2,500 pregnancies involves one of these types of placenta placements: accreta, increta, or percreta. The main symptom of placenta accreta is vaginal bleeding.

Placental Insufficiency

Placental insufficiency is a complication that occurs when the placenta is not able to transfer the necessary nutrients to the baby. Placental insufficiency can lead to:

Low birth weight in the baby
Fetal growth restriction in the baby
Greater risk of oxygen deprivation at birth, possibly leading to cerebral palsy, hypoxic-ischemic encephalopathy (HIE), or other issues in the baby
Developmental delays or learning disabilities in the baby
C-section delivery
Stillbirth
Low blood sugar in the baby (hypoglycemia)
Low body temperature in the baby
Too little blood calcium in the baby
Excess red blood cells in the baby

Symptoms of placental insufficiency may not be present, but any of these can lead to or signify placental insufficiency:

Preeclampsia
Placental abruption
Premature labor and delivery
Small uterus or abdomen

Anterior Placenta

Anterior placenta happens when the placenta develops in the front side of the uterus with the baby behind it. Anterior placenta commonly moves during pregnancy into the more common placement of posterior placenta. An anterior placenta may make it difficult for you to feel your baby’s kicks or make it more difficult for medical professionals to find fetal heart sounds.

It is possible that anterior placenta can signify placenta previa as well, which has its own risks. With an anterior placenta, there is an increased risk of bleeding in the fetus and hypovolemia (low blood potassium), requiring blood transfusions. Blood for transfusions must be emergently available.

What Do I Do If I Have Placental Complications?

If you are experiencing vaginal bleeding or any of the other symptoms identified above, it’s very important to contact your doctor right away. Bring up any concerns you have or changes you notice during pregnancy to your medical team. A doctor will order an ultrasound to diagnose placental complications. Your medical team will take down your clinical history and note your symptoms, which are also important to the diagnosis.

Medical professionals should closely monitor patients with placental abnormalities and administer routine tests and evaluations. Failure to properly diagnose or treat placental abnormalities can be very dangerous for both mother and baby.

Another key aspect to treating patients with placental complications is preparing properly for delivery and delivering at the right time. Your doctor should refer you to a Maternal-Fetal Medicine (MFM) specialist. The MFM specialist will monitor the condition along with your OB/GYN and determine a safe time for birth. If you have a placental abnormality, your doctor should establish a team of medical professionals who will work together to make a specific plan of action for each aspect of the delivery.

In the case of placental insufficiency, your doctor may recommend more frequent office visits, bed rest, education on self-monitoring for symptoms of preeclampsia, steroid injections before 34 weeks if preterm labor is a risk, or kick count records.

If you have a placental complication, it is very important that your doctor educates you properly on your condition, increases monitoring in the presence of the placental complication, and recommends that you see a MFM specialist to receive proper care and preparation for delivery.

Do Doctors Check For Placental Abnormalities?

Placental abnormalities can be diagnosed during prenatal care or during labor and delivery. Some placental abnormalities are diagnosed when your medical team conducts routine ultrasounds. For this reason, it is imperative that medical professionals administer ultrasounds on a regular basis, as needed, and review them meticulously. Other placental abnormalities are diagnosed with a patient history, physical and vaginal exams, and fetal monitor findings.

If you notice any signs or symptoms of placental abnormalities, however, and feel you need to be examined via ultrasound, you have the right to request one at any point during the pregnancy. Because placental abnormalities are often associated with vaginal bleeding, It is especially important that you report any vaginal bleeding to your OB/GYN immediately.

Placental Complications and Medical Malpractice

Unfortunately, medical teams can make errors that lead to placental complications, or they may fail to diagnose a placental concern. As a patient, it’s scary to deal with a pregnancy complication. Finding out that your medical team – the people you entrust with your health and your baby’s health – acted negligently is beyond frustrating.

Some parents don’t realize that their baby’s injury or condition could have been prevented. Sadly, many parents blame themselves for their child’s birth injury. However, medical malpractice is caused by medical professionals or hospital systems that are not following standards of care. It is the responsibility of medical staff to appropriately act if a patient has placental complications or other pregnancy risks.

As a patient, it’s important that you feel empowered to ask questions about your care, know who your providers are, and are informed every step of the way about your care and treatment plan. If you feel something is wrong during prenatal care, or your labor and delivery, don’t hesitate to discuss your concerns with your medical team. If you feel unheard, some hospitals provide patient advocates who can help.

How Can a Birth Injury Lawyer Help Me?

Every day, our nurses and attorneys receive calls from expectant mothers with concerns about symptoms they’re experiencing during their pregnancy. They’re curious if their symptoms are normal, and they wonder what their next steps should be. Patients should always visit a medical professional with concerns like these and receive appropriate care for maternal-fetal conditions and illnesses that can arise during pregnancy.

Unfortunately, there are cases where patients are not heard or properly cared for by their medical staff. It is incredibly frustrating and scary to feel abandoned by the medical team you put your trust in, especially if their neglect leads to you or your baby getting hurt. Our team has successfully worked with parents like you, and advocated on their behalf against negligent hospitals and medical staff.

ABC Law Centers has exclusively worked on birth injury and birth trauma cases for over 25 years. Our multi-million dollar results have helped cover essential and complementary care for children with disabilities from birth injury. While no dollar amount can reverse the trauma of a birth injury, we are gratified to help these families financially make sure their children get the care they need for the rest of their lives.

Our staff knows that parents are busy, which is why we’re available 24/7 for a free consultation via text, call, or email. You can contact us anytime. However, there is a time limit to file legal cases, depending on your location and other factors. We urge you to reach out as soon as you suspect medical malpractice occurred during your child’s birth.

After we conduct an initial consultation, you are not obligated to work with us. If you do, know that our clients never pay anything unless we successfully obtain a verdict or settlement in your favor.

Disclaimer: The information presented above is intended only to be a general educational resource. It is not intended to be (and should not be interpreted as) medical advice.