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What is anterior placenta and associated problems ?

An anterior placenta is an anterior attachment to the uterus wall. A position nearest the spine and to the back wall is the usual position of the uterus, but when the attachment is to the front wall of the womb then it is called anterior placenta. Front positioned uterus does not pose any health risk, but it is inconvenient in some ways. Placement of baby then is to the anterior side, ie., behind the placenta and so it becomes harder to feel the baby due to placenta being in the way. It becomes harder to listen to the sound of the heart and perform amniocentesis for the medical staff. In many cases, anterior placenta moves to posterior side in the later stages of pregnancy.
Placenta grows to the interior of uterus and is a organ that develops in pregnancy. This is a connection or a link that aids in the passing of substances between blood supply of the baby and mother. The two circulations are kept different by the placenta. Placenta makes it possible to pass the oxygen and nutrients from the blood supply of mother to the fetus. Development of placenta depends on the position of fertilized egg implant after coming out of the fallopian tube. There are possibilities of an anterior placenta to attach to C-section scar. This condition is termed as placenta accretes. This is a rare case. The attachment of placenta to the uterus is stronger than usual. This condition has a high risk of severe hemorrhage and hence the delivery of the baby has to be managed very carefully. Blood transfusions in case of need, and a team for surgery shall be needed to perform a hysterectomy upon requirement.
Anterior placenta as it is, does not lead to any problem but when the placenta goes down lower in the uterus then it is likely to cause a problem as it comes in between cervix and the baby. This condition is termed as placenta praevia. This raises the risk of hemorrhage. At times, placenta praevia in initial stages of pregnancy might resolve later with placenta going up higher.

How to detect anterior placenta?
It is found out by an anomaly scan that is carried out at 20 weeks. It tells us about the location of placenta. It is observed as any one of the following:
• Anterior: Implying the placenta is on the front wall of the womb
• Posterior: Implying placenta is on the back wall of the womb
• Fundal: Implying placenta placement on the top wall of the womb
• Right or left lateral: Implying placenta is on the right/left side of the womb

The above mentioned positions of placenta are normal. The risk of having an anterior placenta is bleeding which can be due to:
• The placenta could be lying in a spot where an obstetrician has to perform an incision or cut to deliver the baby.
• The cut/incision to the uterus is way higher than a normal C-section cut in order to minimize the risk of bleeding.
• Low placed placenta, an ultrasound can be used to determine the right position for the cut to be made.
• Growth of placenta over the scar site of a previous C-section which is called placenta accrete.

A MRI or ultrasound aids in diagnosis of a safe C-section birth of a baby. If it is found in an anomaly scan that the placenta is low lying, then a scan between 32-36 weeks is suggested. As uterus expansion takes place, placenta is carried upwards. If even at the end of pregnancy, the placenta is low lying then it is a condition named placenta praevia. Anterior placenta actually covers movements of baby and hence they are noticed a little late.

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