During pregnancy, possible placental problems include placental abruption, placenta previa and placenta accreta.
Placenta Previa:
There are 4 stages of placenta previa - Complete, partial, marginal or normal. These terms tell you where the placenta is attached to the uterus in relation to the cervical opening.
In complete or partial previa, a C-section is required to prevent bleeding as the cervix dilates. If the mother goes into labour naturally, the placenta could detach from the cervical opening prior to the baby being born. This is important because with this type of previa, chunks of the placenta may be lost during the C-section, resulting in a lower capsule yield.
Placenta Abruption:
There are two types of placental abruptions; Complete and concealed.
Complete Abruption - The placenta detaches around the outer rim of the placenta causing a deep uterine wound and allowing the uterine blood vessels to bleed into the fetal space. With complete abruption there is frequently a time lapse in diagnosis and treatment causing death of the fetus. Complete abruption is commonly caused by physical trauma, drug use and smoking in mother during pregnancy, among other things. If there is fetal death due to a complication directly related to the placenta, the chances of getting it returned in a viable manner is slim.
Concealed Abruption (silent abrupto) - This is when the placental outer rims remains attached and the placenta separates from the uterine wall in the middle creating a “pocket” for the blood to clot. The clot can act as a stopper for the bleeding. With most concealed abruptions there are no interruptions to the pregnancy. There will be a large clot imbedded into the placental tissue on the maternal side. This clot will look and feel like red jello and will need to be manually scooped out and disposed of prior to preparation.
Placenta Accreta, Increta and Percreta:
This is when the placenta attaches and imbeds much too deep in the uterine wall causing issues when the placenta needs to naturally detach during the third stage of labor. This is commonly caused by scar tissue present inside of the uterus from previous Csection, abortions, endometriosis and cervical or uterine cancer.
Placenta Accreta - This is the most common type occurring in 75-78% of predisposed pregnancies. There may be retained placenta secundines that will pass on their own post birth or that can be manually removed by the care provider.
Placenta Increta - This is less common than accreta, occurring in 17% of predisposed pregnancies. The mother will most likely require a dilation and curettage to remove all placenta secundines. Chunks of placenta may be unsuitable for encapsulation, yielding fewer capsules.
Placenta Percreta - This is the least common occurring in only 5% of predisposed pregnancies and causing the most issues during the third stage of labor. The placenta can imbed so deep into the uterine tissue that it actually goes beyond the uterus, attaching to the surrounding organs such as the stomach and bladder. Placenta percreta will almost always require a hysterectomy to remove the placenta. You will not receive the placenta back and even if you did there would be no way to adequately separate placenta and uterine tissues.
