QuestionI am a first year student midwife and I am doing a critical review of an article published in the Pregnancy & Birth Magazine (February
2006 issue) titled Bleeding In Pregnancy.
I am wondering if you could help me with this section of the article on placental bleeding and if you can send me references to support or dispute this. This is the quote Im interested
in:
"When the fetus is formed, so is the placenta. Often more (placenta) is formed that is actually required so the excess goes through a natual process of shrinking and dying off, and because it's attached to the lining of the womb it can provoke bleeding as it does this". The article goes on to say that 'the excess that dies away can
creat a clot next to the amniotic sac'. "This is known as a haematoma and can cause painless bleeding any time between six and 12 week".
My midwifery lecturers have said that they have not heard of extra placenta being formed and dying off because it is not required. Can you
help me out here please. I need to ultimately know that if this occurs in a pregnancy, should the woman be worried?
Many thanks
AnswerI have not heard of any "extra" placental tissue. Between 10-12 weeks gestation, while the placenta is forming, there can be a sequestration of blood within the folds of the developing placenta. This is called a "subchorionic hematoma" and usually does not have any effect on the fetus or on the pregnancy. It caues vaginal bleeding and often is worrisome for the patient. It usually dissipates on its own within a few weeks. We advise that the ptient merely observe the bleeding and follow it with serial sonography. I have not heard of any "excess" placental tissue that shrinks and dies off.
