Anterior Placenta during Pregnancy

The placenta develops in the first weeks of pregnancy. This flat, pancake-like organ is attached to the uterine wall and provides the developing baby with the oxygen and nutrients it needs while also removing waste products via the umbilical cord. The placement of this organ can be at the front, back or sides of the uterus depending on where the egg gets fertilised. An anterior placenta pregnancy is when the placenta gets placed along the front of the uterus.

What is Anterior Placenta?

The fertilized egg which will grow to become your baby travels along the fallopian tube and embeds itself along the uterine wall. The placenta forms wherever this egg is embedded – along with the top, sides or in the front and back wall of the uterus. When the egg embeds itself along the front wall of the uterus, it forms an anterior placenta. You will know if you have an anterior placenta pregnancy during the ultrasound scan performed around the 20th week of the pregnancy.

An anterior placenta baby is just as safe as any other baby as its development is not impacted in any way. An anterior placenta pregnancy does the job of nourishing your foetus.

Is it a Problem to Have an Anterior Placenta?

All positions along the uterine wall are normal sites for the development of the placenta. Placental health and the development of the baby does not depend on its placement. Therefore, it is not a problem to have an anterior placenta.

• A pregnancy with an anterior placenta can provide a cushion between your baby and your abdominal surface. This makes it a little difficult to register the first movements of the baby.
• In cases where foetal movements are not felt, even at the week, going for a foetal health assessment reassures mothers.
• Having an anterior placenta can also mean that there are fewer strong movements felt in the second trimester, compared to pregnancies where the position of the placenta is elsewhere.
• Despite its location close to the surface of your abdomen, an anterior placenta does not pose any additional dangers to the health of the foetus. This is because there are many layers – the thick uterine wall, abdominal muscles and fat that insulate it from the exterior world.
• Birth complications caused by an anterior placenta are few. It is only when a C-section is required or when the placenta is placed low on the uterine wall that birth complications may occur.
• The placenta travels over the course of pregnancy and it is possible that a low-lying placenta will move into the upper part of the uterus and cause no complications by the time of delivery.

However, if the anterior placenta is lying very low in the uterus at the time of delivery, it might partly or completely block off the cervix. This would make a caesarean section necessary. This condition, called placenta previa is a rare complication.

What are the Symptoms of an Anterior Placenta?

An anterior placenta has no specific symptoms; it is only detected by the absence of a certain symptom – foetal movement.

• Foetal movements are difficult to feel and are stronger along the sides and lower down because the anterior placenta acts as a cushion between the abdomen and the uterus.
• A handheld doppler will take a little longer to find the foetal heartbeat.
• Having an anterior placenta can also mean that fewer movements are felt in the second trimester relative to pregnancies where the position of the placenta is elsewhere.

If the mother feels no movement by the 23rd week, however, a foetal assessment and an ultrasound are a good idea.

Complications in Pregnancy Due to an Anterior Placenta

An anterior placenta does not in general present any complications during gestation. However, it might seem vulnerable and prone to complications because of its position. This is the exception rather than the rule. The placenta, being a vascular and blood-rich organ, means that any tearing, rupture, cutting or needling poses the risk of excess bleeding. Some of the anterior birth complications are:

• An anterior placenta can pose complications during delivery if a caesarean is required. The anterior placement could make incision placement more complicated or may result in more bleeding during the delivery.
• Complications are faced during needle positioning during amniocentesis. This includes risks of seeding, bleeding, and tears in the membrane.
• An anterior placenta poses the chance of complications like posterior presentation and back labour which causes severe backpain and painful contractions during labour.
• An anterior low-lying placenta has a chance of complications like placenta previa. This may partly or completely block off the cervix, necessitating a caesarean.
• Placenta accreta is a complication faced when the anterior placenta grows over the site of the old caesarean scar and the placenta grows into, and through, the wall of your uterus.

Ultrasound and MRI scans can be used to diagnose all these conditions well ahead of delivery to make sure that plans for a safe caesarean birth can be made.

Is C Section the Only Birth Option?

If one has an anterior placenta, caesarean is not the only option while giving birth. If the vaginal opening is not covered, those having an anterior placenta have a good chance of giving birth normally.

Anterior Placenta and Baby Movement

An anterior placenta acts like a cushion between your skin and the foetus, foetal movements will be detected later on in the pregnancy and be more obvious to the bottom and sides of the abdomen instead of near the navel. Foetal movement and heartbeat of a baby in an anterior placenta pregnancy may be detected with a handheld doppler or fetometer in the first and second trimester. Ultrasounds may be needed to confirm good foetal health after 23 weeks. In the later stages of pregnancy too, it may be hard to feel your baby’s movements. Any changes or abrupt cessation of foetal movement at any stage should be investigated.

Placental Grading

The placenta goes through a process of calcification and maturing over the term of pregnancy. It develops calcium deposits and some parts begin to die, only to be replaced with fibrous tissue. This calcification is the basis of grading of the placenta, with:

• Grade 0

This is from inception in early pregnancy

• Grade I

This is at around 31 to 32 weeks of pregnancy

• Grade II

This is at around 36 to 37 weeks of pregnancy

• Grade III

This is at around 38 weeks of pregnancy, not before 37 weeks

At grade III, the placenta is severely calcified. This calcification is considered a normal part of pregnancy, and not a source of concern.

• Care needs to be taken in cases of premature calcification with pre-existing conditions like placenta previa, diabetes, high blood pressure or severe anaemia. This is because research indicates that if placental calcification occurs before the 32nd week of pregnancy, the baby may have a low birth weight.
• Complications due to placental calcification are not common, and in most cases, calcification does not affect the development of the foetus.

 Factors That Cause Placental Complications

An anterior placenta is not in itself a cause of complication. Complications occur only when it combines with additional conditions like an anterior low-lying placenta, placenta previa or a placental abruption. In all these cases complications happen if a C – section is indicated or if the placenta gets detached from the wall of the womb.

Precautions to Take While Having an Anterior Placenta

Many pregnancy self-help sites and books teach techniques to make things easier during delivery for expectant mothers, which can be summarized as points for placental and mental health Some of the anterior low-lying placenta precautions include:

• Eat well – A well-nourished placenta is a healthy one.
• Drink a lot of fluids – your placenta needs fluids to process all your growing foetus’s waste products.
• Find an exercise with inversions and a stretching plan ideal for you through your pregnancy and try to stick to it.
• Stop worrying – The worst-case scenario is not the most likely to occur. Before you assume the worst, write down your symptoms that indicate this scenario and find out if the symptoms match your fears.
• Do not abuse your body with stress, overwork, alcohol, drugs and over or under eating.

Conclusion – Above all stay happy, a happy frame of mind – more than the placement of the placenta or any medical intervention makes for happy and healthy babies.