The placenta is an organ that connects the mother’s uterine wall with the developing baby. It transports nutrients into the developing fetus, offers thermoregulation, eliminates waste and exchanges gas through the mother’s blood supply. It will also combat the internal infections and helps in hormone production for a healthy pregnancy. The placenta positions itself in the uterine wall that lies on either side or top of the uterus. In some cases, its position varies from the usual ones.
What Is An Anterior Placenta?
Anterior placenta develops when your baby is taking the backseat to the normal placenta. Usually, the fertilized egg implants itself in the posterior uterus, which is near to the spine. But, in some cases, the egg implants in the opposite side, that is the anterior wall of the uterus, which is close to the abdomen. In this case, the placenta develops and grows at the anterior side, i.e., the front of your uterus, with fetus behind it.
When Will You Know If You Have An Anterior Placenta?
In your 20th week scan, which is known as ‘anomaly scan’, the position of the placenta is usually checked. The sonographer will describe the placental position in one of the following ways:
- Anterior – If it implants on the front of the uterine wall
- Posterior – If it implants on the back of the uterine wall
- Fundal – If it implants on the top of the uterine wall
- Right or left – If it implants on the right or left side of the uterus
These are all normal places for placental implant and development. The anterior placenta usually moves away from your baby’s way by the time you deliver.
Does The Location Of Placenta Matter?
It will not matter to your baby. The location of your baby, that is on which side of the uterus he or she is lying, will certainly not make any difference. However, the position can have an effect on you in these below ways:
1. Difficult To Feel Your Baby’s Movements:
The anterior placenta acts as an obstacle between your baby and the uterus. You will not experience any baby movement during the progressing weeks of your pregnancy. Even in the second-trimester, anterior placenta shields the baby’s movements, and you may not feel the kicks.
2. Difficult To Hear Baby’s Heartbeat:
It will be difficult for your doctor or midwife to hear the fetal heart beat. However, it will not interfere with any ultrasound scan or while finding out your baby’s gender.
3. Interferes With Medical Procedures:
Anterior placenta position may interfere with amniocentesis, a medical procedure. If your baby is lying in a transverse position or breech position, the anterior placenta poses a problem for bringing him out.
The above situations will settle if the placenta gets back to the posterior position that commonly happens in late pregnancy. In spite of the above difficulties, the anterior placenta will not cause any risks to you or your baby’s health.
When Can You Feel The Fetal Movements?
The exact time when you can feel your baby’s movements for the first time may vary between a normal placenta and an anterior placenta. Usually, pregnant women feel the baby movements around 22nd week. Women with anterior placenta can feel them a little later. But if it later than the 24th week, consult your doctor. The movements progress through the advancing weeks wherein you may regularly count your baby kicks and recognize her sleep-wake patterns.
Complications Associated With Anterior Placenta:
Your health practitioner will monitor your womb with ultrasounds in the weeks 32 to 36 to check the placental location. You can have a natural delivery as the placenta moves upwards as your baby grows. Thus, it will be out of the way by the time of labor. However, it may lead to some complications in a few cases.
1. Placenta Previa Or Low Lying Placenta:
If the placenta does not move upwards and remains in the lower uterine part even after reaching the 33rd to 34th week of pregnancy, it may lead to placenta previa. You may have an ultrasound scan to help your practitioners find the best position to do an incision. It will, therefore, require you to go for a caesarean section. It may also keep you at greater risk of premature labor.
2. Back Labor And Other Complications:
Some women may have back labor leading to severe back pain and contractions. It depends on your baby’s position and your health. A few women may have back labor if babies are facing the mother’s abdomen (occiput posterior), or facing the mother’s belly. You are also likely to have back labor when your baby faces your spine.
If you had a caesarean section in the previous pregnancy, it is likely that the placenta grows on the site of the scar and the uterine walls. It is a rare condition, but ultrasound and MRI scans can diagnose it.
In one research study, it was found that anterior placenta position may cause certain health complications like gestational diabetes, placental abruption, intrauterine growth retardation and pregnancy induced hypertension (1).
Is Cesarian Section The Only Option In Case Of Anterior Placenta?
The cesarean section is not the only option if you have an anterior placenta. But if placenta stays in the same place by covering the cervix even at 40 weeks of pregnancy, a normal delivery is not possible. In a few cases, the placenta partially or completely moves from the uterus, signaling a cesarean section.
Research Related Conclusions About Anterior Placenta:
- The birth weight of babies is more with anterior placenta than the normal pregnancies. The same study reveals that the anterior placenta is more likely with female births (2).
- Although anterior placenta poses no pregnancy risks, a study shows that the placental position may increase the chances of hypertension, placenta damage, gestational diabetes, slow fetal growth, and fetal deaths. It also reveals that women with O-positive blood group are more likely to have anterior placenta during their pregnancies (3).
- The sleep position of women during the time of embryo implantation might influence the position of the placenta (4).
- Another study concludes that the anterior placenta can increase the need for labor inducement and caesarean section. It can delay the start of labor. There is also a high risk of postpartum complications such as postpartum hemorrhage (PPH) during vaginal deliveries (5).
What is Placenta Grading?
Placenta grading (6) refers to an ultrasound grading of the placenta based on its maturity. It reflects the age of placenta that goes from grade one to three as your pregnancy progresses.
Placenta begins with grade zero at an early pregnancy. As pregnancy advances, the it calcifies and matures.
- It is the late first trimester to early second trimester i.e., less than 18 weeks.
- The chorionic plate is straight, smooth and a well-defined unbroken dense line.
- The placental substance is a uniform echotexture with no echogenic areas.
- No basal layer echogenicities
- It is the mid-second trimester to early third trimester i.e., 18 to 29 weeks.
- It is the early stage of placental maturation.
- The chorionic plate is a well-defined unbroken line which may have fine undulation.
- The placental substance contains a few echogenic areas that are randomly dispersed.
- It is the late third trimester, i.e., beyond 30 weeks.
- The chorionic plate has more marked indentations.
- The placental substance is incompletely divided with linear echogenic densities.
- Larger calcifications are present in the basilar plate with a ‘dot-dah’ configuration.
- It is beyond 39 weeks, i.e., the late phase representing mature placenta.
- The chorionic plate had complete indentations.
- The placental substance is divided into compartments that demarcate the cotyledons.
- Basal layer is denser and larger.
Factors That Affect Placental Health:
A properly functioning placenta is necessary for a good fetal health. Placental complications can result in growth anomalies and even fetal death. Some of the factors that affect placental health are as follows;
- High blood pressure
- Pregnancies over the age of 40
- Multiple pregnancies
- Uterine surgeries before the pregnancy
- Pre-labor ruptures in the amniotic sac
- Blood clotting problems
- Illegal drug or any other substance abuse during pregnancy
- Abdominal injuries
There are some measures to look after your placenta. They include:
- Do not give sudden jerks to your body by dropping yourself into forward-leaning inversion suddenly. Wear a seat belt while traveling. Avoid smoking and drugs that may harm your placenta and your fetus.
- Eat more leafy green vegetables, whole grains, nuts like almonds and healthy fats such as those present in avocado. Also, minimize the intake of salt and processed foods. Indulge in foods that are easy to digest.
- Exercise only if your doctor allows you. Follow the physical activity parameters set by your doctor. Pelvic floor exercises, brisk walk, and prenatal yoga are a few examples.
- Take care to minimize sudden movements such as forward bends or twists.
- Keep up with your scheduled check-ups during your pregnancy. Regular check-ups help your doctor take care of any problems in time. These checkups can help your doctor to suggest precautionary measures in case of anterior placenta complications.
- In case you experience any abdominal pain or vaginal bleeding during pregnancy, contact your doctor immediately. The pain may be harmless, but it is imperative that your doctor checks the source of the pain. If the pain is due to placental detachment, any delay in medical attention can be fatal. Also, report to your doctor if you experience back pain, premature uterine contractions or any abdominal trauma.
The anterior placenta risks that arise are manageable as ultrasound scans reveal most potential problems beforehand. It is a common placental position and doctors can handle pregnancies with any placental position. An anterior placenta is not a cause for concern. All you need to do is follow your doctor’s suggestions and keep stress at bay. So, eat healthy, sleep better and enjoy your time now, as it is special.
Did you experience any problems during your pregnancy due to anterior placenta? Please share your experiences with us.
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