Placental Disorders

About Placental Disorders

Placental disorders encompass a range of conditions affecting placental development, function, or attachment that can compromise maternal and fetal health. These disorders include placenta previa, placental abruption, placenta accreta spectrum, and placental insufficiency, each presenting unique risks during pregnancy and delivery. Early recognition and appropriate management are crucial for optimizing outcomes for both mother and baby.

Pathophysiology

Placental disorders arise from abnormal implantation, vascular development, or structural integrity of the placenta. Placenta previa results from low implantation covering the cervical os, while abruption involves premature separation due to bleeding into the decidua basalis. Placenta accreta spectrum disorders occur when placental villi invade beyond the normal decidual plane due to deficient decidua basalis, often associated with prior uterine scarring.

Clinical Reasoning

Diagnosis relies on clinical presentation combined with imaging studies, particularly ultrasound and MRI for structural abnormalities. Placenta previa typically presents with painless vaginal bleeding, while abruption causes painful bleeding with uterine tenderness and contractions. Management strategies range from expectant monitoring with activity restriction to emergency cesarean delivery, depending on gestational age, bleeding severity, and maternal-fetal stability.