Problems with the placenta

In many cases, problems with the placenta are detected before labour starts. Possible complications associated with the placenta include placenta previa and placental abruption. Problems with the placenta can cause problems with the oxygen supply to the baby and the baby may consequently become distressed; in many cases where the baby needs to be delivered quickly, the doctor will recommend a caesarean section.

• Placenta previa

This is a condition which occurs when the placenta is blocking the cervix; there are three types of previa including complete, partial and marginal previa. Placenta previa occurs in around 0.5 percent of pregnancies. In many cases, the condition is diagnosed during the latter stages of pregnancy and is usually characterised by painless vaginal bleeding. Once diagnosed, mothers with placenta previa will be advised to rest and they may be given shots of steroid; this will help the baby’s lungs to mature more quickly and will be beneficial if the baby is born premature.

Placenta previa can be extremely dangerous at full-term; it can cause haemorrhaging, congenital health conditions and can potentially prove fatal. If the previa is still present at full-term, the mother may be advised to have a caesarean section.

Risk factors for placenta previa include:

• Multiple births
• History of placenta previa: you are more likely to have placenta previa if you had it in previous pregnancies
• Age: older women are more likely to suffer from placenta previa
• Using cocaine
• Smoking
• If you have had a caesarean section in the past

• Placental abruption

This is a very serious condition, which occurs when part, or all, of the placenta comes away from the wall of the uterus before the baby is born. The condition can cause the oxygen supply of the baby to become disrupted and may contribute to haemorrhaging, which can be very serious. Placental abruption also increases the risk of premature labour.

Signs to look out for include:

• Tenderness in the uterus
• Back ache
• Vaginal bleeding (this may be light or heavy)
• Abdominal pain
• Cramps

You should contact your doctor immediately if you experience any of these signs or symptoms.

If the abruption occurs near the due date, the baby will be delivered immediately by caesarean section; however, if the abruption is minor and there is still a way to go with the pregnancy, the mother may be given medication to delay labour and steroids to help the baby’s lungs to mature more quickly.

Risk factors for placental abruption include:

• History of placental abruption in previous pregnancies
• Age: the risks are slightly higher in older women
• Smoking and using cocaine
• Blood clotting disorders
• Having twins or triplets
• Trauma or an accident
• Hypertension or preeclampsia