A placental injury may occur in more than one way. The placenta may pull away from the wall of uterus too early, it may not be delivered quickly enough after the baby is born, or part of the placenta may remain inside the mother’s uterus or cervix after childbirth. All of these placental injury-type events have the potential for serious consequences to the mother and/or the child if appropriate placental injury treatment by competent, well-qualified obstetric medical professionals is not provided in a timely manner.
Common Placental Injuries During or Immediately Prior to Childbirth
Placental Abruption
Placental abruption, otherwise known in medical terminology as placental abruptio, is defined as the gradual or sudden withdrawal of the placenta from the wall of the uterus prior to childbirth and labor. Placental abruption is defined by medical practitioners as either partial or complete abruption from the uterine wall. During the course of a normal pregnancy, the placenta stays firmly in place until after the child is delivered before detaching from the wall of the uterus on its own as part of the childbirth and labor process. When this type of placental injury occurs, the mother may experience vaginal bleeding, which can be severe. Depending on the degree of the abruption, the developing infant may not receive the proper level of oxygen and nutrients. In nearly eighty percent of cases, pregnant mothers experiencing placental abruption will notice vaginal bleeding, alongside the possibility of acute contractions and abdominal sensitivity, comparable to the sensation of menstrual cramps.
Retained Placenta
In the case of a retained placenta, the childbirth process fails to discharge the placenta following the birth of the child, which ultimately jeopardizes the health of the new mother.
There are two ways in which placental retention may manifest, including:
- If the placenta is not delivered within 30-60 minutes after the child is born (full placental retention)
- If only part of the placenta breaks off and is retained inside the mother’s body instead of being delivered intact (partial placental retention)
Common Medical Approaches to Placental Injury Treatment
Medical professionals will categorize the severity of a placental abruption into grades of zero to three, with a grade zero placental abruption featuring no symptoms until after the childbirth process. In contrast, a grade four placental abruption features significant, life-threatening vaginal bleeding causing the death of the child and leaving the mother in a state of hypovolemic shock from blood loss. Medical professionals are obligated to identify these gradients of placental injury correctly, then apply a professional standard of care to each patient, whose needs are entirely case-specific and complicated by the fact that two patients (both mother and child) are being treated.
Consequences of Placental Injuries if Left Untreated
For mothers, if a placental abruption occurs, the possible consequences to the mother depend on the stage of pregnancy when the complication is observed by either the mother or the attending medical professionals. In cases of significant vaginal bleeding stemming from placental injury, the mother may require blood transfusions. In cases of severe, traumatic bleeding, the mother is at risk for renal failure and going into shock. Likewise, a retained placenta can also cause bleeding after delivery and put the new mother at an increased risk of infection.
For newborns or unborn infants, if a fetus is deprived of oxygen and nutrients due to a placental injury during the gestation period or during the birth process, he or she is at higher risk for premature birth, learning difficulties, brain damage and cerebral palsy (from lack of oxygen). Stillbirth is also a possibility if the oxygen supply is interrupted long enough.
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