The Placenta: Life Support for the Baby—or a Silent Risk?

Deep within the womb, the fetus’s heart beats, though it cannot yet breathe, eat, or eliminate waste on its own. This highlights the vital role of the placenta—an extraordinary organ that acts as the baby’s lungs, stomach, filter, and immune shield. It is the lifeline connecting mother and child. However, the placenta can sometimes become a serious risk to both the baby and the mother if not carefully monitored.

In this report, we speak with Dr. Laila El-Sheimy, Professor of Obstetrics and Gynecology, who explains how the placenta forms, its essential functions, and when it can turn from protector to potential threat.

What Is the Placenta and What Does It Do?

The placenta is a temporary organ that forms exclusively during pregnancy. It begins to develop just a few days after the embryo attaches to the uterine wall. It is connected to the baby via the umbilical cord and is typically attached to one of the uterine walls—either front (anterior), back (posterior), upper, or lower.

Key functions of the placenta include:

• Delivering oxygen and nutrients to the baby

• Removing waste products and carbon dioxide from the baby’s blood

• Producing vital hormones such as progesterone and estrogen

• Protecting the baby from certain infections

• Preventing the mother’s immune system from rejecting the fetus as a foreign body

How Do Doctors Assess Placental Health?

Through ultrasound (sonography), doctors can evaluate:

• The placenta’s position (anterior, posterior, low-lying, or previa)

• Its thickness and functionality

• Any signs of calcification or partial separation

• Blood flow through placental vessels

When Can the Placenta Be Dangerous?

Although it is the baby’s lifeline, the placenta can develop complications that threaten the health of both fetus and mother. Some of the most serious conditions include:

1. Placenta Previa

This occurs when the placenta implants in the lower part of the uterus, covering the cervix partially or completely.

Risks:

• Obstructs vaginal delivery

• Usually requires a scheduled cesarean section

Symptoms:

• Painless vaginal bleeding in the second or third trimester

• Often discovered incidentally on ultrasound

In many cases, the placenta “moves up” as the uterus expands, reducing the risk over time.

2. Placental Abruption

A medical emergency where the placenta detaches partially or fully from the uterine wall before delivery.

Risks:

• Oxygen deprivation to the fetus

• Heavy maternal bleeding

• Premature birth or stillbirth

Symptoms:

• Sudden, persistent abdominal pain

• Vaginal bleeding

• Continuous uterine contractions

• Decreased fetal movement

Treatment:

Immediate delivery may be required, especially in complete abruption.

3. Placental Insufficiency

Occurs when the placenta fails to deliver adequate oxygen and nutrients to the fetus.

Risks:

• Intrauterine growth restriction (IUGR)

• Preterm delivery or low birth weight

• Fetal demise in severe cases

Signs:

• Small fundal height for gestational age

• Reduced fetal movement

• Abnormal ultrasound findings

Management:

Close monitoring; early delivery may be necessary.

4. Placental Calcification

Calcium deposits on the placenta are common near the end of pregnancy, but if they appear before 32 weeks, they may signal trouble.

Risks:

• Reduced placental efficiency

• Growth restriction or low amniotic fluid

5. Chorioamnionitis (Placental Infections)

This is a bacterial infection of the placenta and amniotic fluid, typically from ascending infections through the cervix.

Symptoms:

• Maternal fever

• Foul-smelling vaginal discharge

• Rapid fetal heart rate

Complications:

• Preterm labor

• Neonatal respiratory infections

• Life-threatening risk to both mother and baby if untreated

6. Placenta Accreta

Here, the placenta attaches too deeply into the uterine wall and fails to detach after delivery.

Risk factors:

• Previous cesarean section

• Low-lying anterior placenta

Complications:

• Severe postpartum hemorrhage

• May require hysterectomy to save the mother’s life

How to Maintain a Healthy Placenta

• Attend all regular prenatal checkups

• Avoid all exposure to tobacco smoke

• Don’t take any medication without consulting your doctor

• Monitor daily fetal movements

• Eat a balanced diet rich in iron and folic acid

• Drink plenty of water to maintain healthy amniotic fluid levels

• Seek immediate care if you experience bleeding, pain, or reduced fetal movement

Does Placental Position Matter?

Yes—placental location can affect your experience during pregnancy and labor:

• Anterior placenta may cushion fetal movements, making them harder to feel early on

• Posterior placenta is generally ideal and causes few complications

• Low-lying or previa placenta may necessitate a cesarean delivery

When Should You Be Concerned About the Placenta?

Call your doctor right away if you experience:

• Vaginal bleeding

• Abdominal pain

• Decreased fetal movement

• Sudden changes in amniotic fluid

• A spike in blood pressure or protein in urine