What causes a placenta to "fall apart"? - Mothering Forums

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#1 of 18 Old 12-15-2005, 03:00 AM - Thread Starter
 
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Hi ladies,

I was wondering if you could share some insight ...

My dear cousin had a baby girl last week. She was 11 days "overdue" and was induced using a new tape / hormonal method.

The baby was born fine after about 10 hours of labour, but the staff had trouble removing the placenta. I assume they gave my cousin a syntocinon shot and were doing cord traction, as my cousin told me the cord was snapped.

So she was given an epi and the placenta was manually removed. The staff told her the placenta was all mushy and was coming out in chunks, and my cousin had to stay in hosptial for a week to monitor for any signs of infections, as they weren't sure they'd got all the pieces out.

What could cause a placenta to "fall apart" like this?

Could it be due to the managed third stage, or is it a sign of postmaturity?

I also think it's a bit rough that she delivered her nine pound baby with no tears, then got cut by the doctor during the placenta removal.

Kath contented vegan mama to my trio of free-range boys
Permaculture Design Student & Wannabe Urban Homesteader
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#2 of 18 Old 12-15-2005, 03:31 AM
 
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I don't think it's an issue of the placenta - it's an issue of extreme overmanagement of the providers.

Chances are, they were only giving her a certain amount of time to birth the placenta, like they only gave her a certain amount of time to birth her baby.

I wouldn't even think it was the placenta - placentas are amazing things, always changing to keep our babies alive, no matter what it takes.

Her placenta was more than likely ripped to shreds because of impatience.
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#3 of 18 Old 12-15-2005, 06:36 PM - Thread Starter
 
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Thanks for the reply Pamela.

That was my suspision too.

Kath contented vegan mama to my trio of free-range boys
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#4 of 18 Old 12-15-2005, 06:45 PM
 
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In my personal experience, my placenta came out in tiny tiny pieces. I had a medicated labor but a natural childbirth since we turned the epi off for pushing...(OP baby with 40 hours of labor then 3 hours of pushing..I was pooped!) My placenta just was that way. My m/w said it was called a *duncan placenta* or something along those lines. I just hope it doesn't happen again...it was more painful than the birthing, IMO.
In your case, it sounds like they were just a little too quick to have everything completely in a timely fashion instead of just waiting awhile.

A doula who married a cop & became a mama to 3 boys: G 12/22/00, my rainbow baby B 2/2/07 and L 2/10/10 my CBA2V baby, waiting for my little caboose late February 2013 & always remembering my two angels 2006 & 2012.

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#5 of 18 Old 12-16-2005, 01:38 AM
 
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I saw this once...it was really odd. I was at a friend's birth (in hospital). Straightforward labour, pretty quick for first time mom, had a shot of Demerol early on, no other meds, pushed in squatting position, no rushing from the staff - not too bad for a hospital birth. There was some question about dates but she was approx. 42 weeks. Baby was born fine, the doc was pretty hands-off about the placenta, waited 1/2 hour before doing anything. The placenta ended up coming out in these little unhealthy-looking pieces. It looked all ratty like an old blanket! It was definitely not just pieces of a normal, healthy placenta. The colour was off, it looked dry, just...not right. It didn't all come out and she started to bleed quite a bit, so they called in the OB for a manual removal, and got more ratty little bits out, and then had to take her for a D&C. EBL before arriving in the OR was about 1500 ml.

I have always wondered why this happened, but never heard any explanation for it. I don't know if the placenta bits were sent to pathology but if they were, I don't think my friend was informed of any findings.
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#6 of 18 Old 12-16-2005, 04:26 PM
 
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Is that not a symtom of a placenta that is starting to "die", for lack of a better term? I have heard/read/discussed that they have a finite lifespan, do their job and then start wearing out. I knew a mom whose placenta looked as if it was breaking down, as described above, and there were pieces left inside. It just did not look vital and healthy, it looked aged and worn out. The mom was post dates by only a week and a half, or so they guessed. Perhaps it was more. I know there is a lot of talk about not rushing into induction for moms who are deemed overdue, and I agree, but I do think there is a point where the placenta starts to wear down and complications can arise if it is left too long. It is judging WHEN the actual due time is that seems tricky.
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#7 of 18 Old 12-16-2005, 09:25 PM
 
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definitely at the end of pregnancy, the placenta is a bit tired, but in healthy pregnancies, it doesn't usually "die", but change function. It's one reason why the blood pressure increases that last month - to pump a higher volume of blood to the placenta.

I don't really buy the medical theory that placentas in healthy women just "die" because of dates. I think what happens is that in unhealthy women or in comprimised women the placenta works harder and harder and will eventually start labor in order to avoid comprimising the baby. I believe that this is one reason why some women go earlier than others.

The placenta is an amazing organ - one of the recent issues of Mothering has a great article on the placenta by Sarah Buckley. We really view the placenta in very abstract terms, when in fact, it isn't what it looks like when it comes out, but how it performs that makes us scratch our heads in awe.
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#8 of 18 Old 12-17-2005, 12:04 AM
 
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My sympathies to your cousin BTW, it sounds like she endured unnecessary rough treatment, poor thing.

I asked my own midwife about this, and she answered "both". It can be due to some pathology or health issue with the woman, it can be due to postdates, for some women it is just what "happens" (she had a client with 3 kids for whom this sort of thing happened each time; necessitated hospital birth with #3 due to the difficulties she had with bleeding and infection from the first 2; the mom was 2+ weeks every time, just carried babies for a longer time than the usual 40 weeks).

I hope your cousin is recovered now and able to enjoy her baby! Peace
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#9 of 18 Old 12-17-2005, 12:35 AM
 
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With ds1, my OB pulled on the cord to deliver the placenta (as he had done w/my first w/no problems) and the cord detached. He had to manually retrieve it (sounds much less painful than it was- I didn't have an epidural or anything) and said it was b/c in preemies, the cord is sometimes weak and that's why it broke. All of my kids were 5 weeks early. I'm sure it was just his impatience, though I didn't know that at the time. Doc was in and out in 30 minutes.

Also, my placenta came out in pieces, but I'm pretty sure it was from doc digging around, not b/c the actual placenta had any problems.

Moral of the story, if there's a placenta problem, it MUST be b/c of due date issues, not dr error.

Michelle -mom to Katlyn 4/00 , Jake 3/02, and Seth 5/04
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#10 of 18 Old 12-17-2005, 05:28 AM
 
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We had the same situation recently, which is very rare with our midwives. I can't remember the other one, but in this one I remember the midwife mentioned that there is new literature that is now drawing correlations to GBS and placentas that shred. Also, in this mom the uterus was almost bi-lobed, and part of the placenta had lodged in one of the "lobes" in the upper right section. My sympathy to your cousin. That's rough. Hopefully the memories of a beautiful birth will overshadow the negative part in time.
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#11 of 18 Old 12-17-2005, 10:55 AM
 
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This is an interesting topic, I have had a few discussions about it with doula, midwife, and ob freinds since you posted it... A couple of OB nurses I know have witnessed many cases of OB impatience of course, and seen them do ridiculous, awful things in their haste regarding the placenta. One friend threw her hands up and cried "It's like they order an automatic D& C DIRECTLY after the baby is born!! And when it comes out all torn up they attribute it to some health problem or "compromised" placenta, which is not always the case. My midwife with the mom of 3 with the "ragged" looking placentas said they were born without assistance or force, and that this mom just had that kind of thing happen... If the docs go digging for it and are pulling, snapping cords and such, I am sure their actions are more the cause for the "falling apart" appearance.
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#12 of 18 Old 12-20-2005, 12:45 AM
 
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I know a woman whose Ob told her that the cord snapping when he pulled on it was due to her overconsumption of coca cola. Now that made me laugh I'd suggest a poor grasp of anatomy there if he thinks her placenta is wallowing in undiluted cc. Anyhoo... This is a useful little article about placentas too>

http://www.ncbi.nlm.nih.gov/entrez/...0&dopt=Abstract

Midwifery. 1991 Mar;7(1):31-9. Related Articles, Links


A contemporary view of the human placenta.

Fox H.

Quote:
Our current knowledge of the human placenta is briefly reviewed. Particular stress is placed upon the considerable functional reserve capacity of the placenta, the unimportance of most visible abnormalities of the placenta, the lack of any evidence that the placenta ages during gestation and the lack of significance of placental weight. The effects on the placenta of infection and of maternal cigarette smoking are considered and the concept of placental insufficiency critically discussed. It is concluded that most cases of 'placental insufficiency' are, in reality, examples of maternal vascular insufficiency resulting from inadequate placentation during the early stages of pregnancy.
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#13 of 18 Old 12-20-2005, 06:29 AM
 
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Why, why, why do we think we must go in and manually remove a placenta after the cord has broken (due to pulling or otherwise) ? We will birth our placentas with or without the cord. There is some thought that we will have bleeding, but that simply does not need to be a fear. The uterus will continue involution, the placenta will shear off and it will come down and be pushed out.

I think squatting to deliver placentas is wonderful, we don't have to "pull on the cord." I am amazed at how many midwives do this! You could argue expectant management vs. active management.

Oh gosh and they cut her to do a manual removal?! Eek!
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#14 of 18 Old 12-20-2005, 05:24 PM
 
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And doesn't it follow that the cord snapping is more of a problem for baby than mom, as the babe then does not get that blood supply from placenta right at birth? But for Mom, the placenta would be born just as it would have if the cord were still attached? Are there any docs who wait and see if this is true!?

Now what about placental calcification, as mentioned in another post I read here somewhere... when do yall feel this becomes a problem/risk and how does that fit into our discussion of post dates? Is it only due to post dates? Just wondering...
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#15 of 18 Old 12-21-2005, 01:46 AM
 
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My post answers that
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#16 of 18 Old 12-21-2005, 03:50 AM
 
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also, just like with smokers, calcified placentas that will inhibit the health of the baby will often "grow" and spread out to find "new" virgin places on the uterus for more blood flow.

we think we know alot about the placenta, but based on current belief systems and myths being spread, it's obvious that the placenta is far smarter than we think we are.
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#17 of 18 Old 12-21-2005, 11:10 PM
 
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And ain't that the truth about so much in birth!
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#18 of 18 Old 08-22-2013, 04:58 PM
 
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I know this is a very old thread, but I wish someone had some more answers. In my last two pregnancies I was told that my placenta was disintegrating. One baby was born at 37 weeks after my water broke. She was born with complications similar to what a preemie would suffer as a result of not getting proper nutrition, oxygen etc through an unhealthy placenta. In the second pregnancy with this problem, we had a stillborn. This was all very very hard on us. No one seems to know what might be wrong. Except with regard to pregnancies, I am a healthy adult. No smoking, no high blood pressure, no drinking, drugs, no diabetes, not overweight. No problems. Except with regard to carrying babies. Any ideas what could cause this?? 

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