Anterior Placenta: What It Means, Effects And Home Care Tips

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The placenta is a highly specialized organ that develops during pregnancy. Anterior placenta is usually a harmless condition where this organ attaches to the front of the uterus (womb) instead of the posterior area.

The placenta helps supply oxygen and nutrients to the developing fetus and carries away waste materials. In addition, it protects the baby from infections and produces hormones for the smooth progress of pregnancy and childbirth (1).

Read on to know more about anterior placenta, including whether it affects the baby’s growth or your labor and delivery. Also, learn about some signs that indicate you should consult your doctor and some home care measures to follow.

What Is Anterior Placenta?

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An anterior placenta is when the placenta attaches itself to the front of the uterus, close to the abdominal wall.

While the placenta can attach itself anywhere in the uterus, it usually develops in the posterior (back) side, close to the spine. In the anterior placental position, most of the fetal movements are masked by the placenta and may not be detected.

An anterior placenta is a rare phenomenon and is more likely to happen if you had a cesarean earlier (2).

When Will You Know If You Have An Anterior Placenta?

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The doctor checks the placental position in the 20th-week scan, which is also referred to as the ‘anomaly scan’ (3). The placental location can be described as:

• Anterior: Implants on the front of the uterine wall

• Posterior: Implants on the back of the uterine wall

• Fundal: Attaches to the top of the uterine wall

• Right or left lateral: Implants on the right or left side of the uterus (4)

• Placenta previa: The placenta is positioned over the cervix (the opening of the uterus).

Does Anterior Placenta Affect Your Pregnancy?

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An anterior placenta is not a cause for concern, but it might make certain things difficult.

1. Fetal heartbeat: Usually, you would be able to first hear the baby’s heartbeat between the 10th and the 12th week of gestation (5). It may be detected either by a hand-held DopplerⁱA form of ultrasound that is used to examine blood flow or a fetoscopeⁱA specially developed stethoscope for monitoring the fetal heartbeat . In the case of the anterior placenta, that might be difficult since the placenta is between the hearing aid and the fetus.

Recalling her diagnosis of the anterior placenta, Emiline, a mother, says, “At my 12-week appointment, Dr. Nielson got out his handy doppler to listen for baby Loinette’s heartbeat. ‘I just heard it, but I want to get a better listen for you,’ he said. I smiled. ‘I expect you to have an anterior placenta, so we’re listening through your skin and an entire placenta to hear the heartbeat. That’s why it’s so hard to hear,’ Dr. Nielson says. ‘Is that bad?’ I say. ‘No. It just means your baby is implanted in the back of your uterus, and the placenta is in the front,’ he says (i).”

2. Baby’s kicks: You cannot feel the baby’s kicks and movements since the placenta acts as a cushion between your abdomen and the uterus. In the case of an anterior placenta, you could feel muted movements and delayed kicks when compared to those with a posterior placenta.

Be watchful

If you’re diagnosed with an anterior placenta, focus on feeling your baby’s movements near the sides or lower part of your belly, as movement tends to be more noticeable in these areas (17).

3. Baby’s position: Since the movements cannot be appropriately detected, it might not be easy to determine the baby’s position.

This prevents you from learning about the baby’s development as easily as the other mothers could. And that is annoying!

Does Anterior Placenta Affect Your Baby’s Growth And Development?

The anterior placenta may not affect the baby’s development or health. It may not make any difference to the fetus as long as it is cushioned in the placenta.

Does Anterior Placenta Affect Your Labor and Delivery?

There is a chance of normal delivery even with an anterior placenta, as long as the vaginal opening is not closed. Even in this case, the placenta during pregnancy gets separated from the uterine wall and is removed and sent for analysis, if necessary.

However, research states that the anterior placenta might increase the need for labor inducement and a cesarean section. It might also delay the start of labor. There is also a slightly higher risk of postpartum hemorrhageⁱHeavy blood discharge from blood vessels after childbirth (PPH) during vaginal deliveries (6).

What Are The Complications Of Having An Anterior Placenta?

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An anterior placenta might not cause any complications during pregnancy. However, it could create complications during labor and delivery, when it grows towards the cervix instead of growing up towards the uterus.

• It might pose risks during a c-section. The placental position could make the incision more difficult, thereby resulting in heavy bleeding during delivery. The anterior placenta may, therefore, increase the risk of excess bleeding during vaginal delivery too (6).

• Needle positioning may become challenging in the case of amniocentesisⁱAn amniotic fluid sample test done to diagnose specific genetic abnormalities and birth problems , resulting in bleeding and tears in the membrane.

• Women with an anterior placental position are likely to experience low back pain (7). You may develop back labor, which is a severe pain in the back that occurs with the contractions during labor.

• A low-lying anterior placenta might increase the chance of placenta previa, which might partly or completely block the cervix, increasing the need for a c-section (8).

• Anterior placenta over an old C-section scar might lead to placenta accreta (9), which causes the placenta to grow deep into the scar and also the uterine wall.

• When the baby is in the breechⁱIt refers to the fetus in the longitudinal position, with the buttocks and feet facing the pelvis position, your doctor performs a cephalicⁱ A procedure that involves exerting external pressure on the fetus to move its head toward the pelvis presentation for a smooth vaginal birth. But with an anterior placenta, it might not be possible to turn the baby from a breech position to head-down position, especially if it is low-lying anterior placenta (10).

Research finds

A study found that women with an anterior placenta may experience a longer third stage of labor and have a higher likelihood of needing manual placenta removal (6).

An ultrasound and MRI scan during your prenatal care visit might help in fetal monitoring and detect the above conditions so that the doctor can plan for a cesarean delivery accordingly.

The anterior placenta is also known to increase the risk of  (8).

• Pregnancy-induced hypertension
• Gestational diabetes mellitusⁱA condition in which a placental hormone prevents the body from adequately using insulin, leading to increased blood glucose
• Placental abruptionⁱWhen the placenta separates from the uterine inner wall before the baby is born
• Intrauterine growth retardationⁱPoor growth of the baby in the uterus due to lifestyle practices or specific health conditions
• Intrauterine fetal loss

These risks to the mother and the child could be rare. Regardless, it is best to consult a doctor to stay safe.

When To See A Doctor?

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Check for the following signs and symptoms that might indicate placental issue:

• Strong uterine contractions
• Abdominal pain
• Vaginal bleeding
• Severe back pain

If you have suffered an impact on your belly during a fall or trauma, get the injuries checked by a doctor. These injuries might affect placental health and amniotic fluid level, warranting a medical examination.

Besides the doctor’s recommendations, a few homecare tips could also help to maintain placental health.

Home Care In The Case Of An Anterior Placenta

The following measures will keep up the placental health irrespective of any position. They will also make labor easy, thus keeping both the mother and the baby healthy.

• Eat well for nourishing the placenta. Include more leafy green vegetables, whole grains, nuts, and healthy fats. Minimize the consumption of processed and salty foods.

• Hydrate yourself by drinking more water and juices. Placenta requires fluids to drain the fetal waste.

• If you are allowed to exercise, brisk walking, prenatal yoga, and pelvic floor exercises can be helpful. Take precautions, and do not overdo them (12).

• Avoid sudden jerks to the body – don’t plop on to the sofa or drop yourself into a forward-leaning inversion suddenly. Minimize sudden movements such as forward bends or twists. Wear a seat belt while traveling.

• Avoid smoking and narcotics that may harm your placenta and fetus (13).

Studies About Anterior Placenta

• In a retrospective Turkish study of 500 healthy pregnant women, it was found that the birth weight of fetuses with anterior placenta was higher compared to normal placental pregnancies. Also, the incidence of an anterior placenta was found to be higher in the case of female births.

• Another study conducted in Abha General hospital of Saudi Arabia showed that the majority of women with an O-positive blood group had an anterior placenta (8).

• Sleep position during conception also influences the placental implantation site, found another study carried on singleton pregnancies of gestational weeks between 15 and 20 (14).

The maturation of the placenta, according to the gestational age, is explained through a detailed classification system, which we talk about next.

Placental Grading (Grannum classification)

Placental grading is the classification of the ultrasonographic morphology of the placenta, based on its maturity. It reflects the extent of calcificationⁱHardening of a part of the body such as the tissue, blood vessels, or organs due to accumulation of calcium in those parts with the gestational age. The placenta is grouped into four grades, from grade zero to three (11).

Grade 0:

• Gestational age: between late first trimester and early second trimester, i.e., less than 18 weeks of gestation.

• The chorionic plate is straight, smooth, and a well-defined, unbroken dense line.

• The placental substance is a uniform echotexture with no echogenic areas.

• No basal layer echogenicities

Grade 1:

• Gestational age: mid-second trimester to early third trimester, i.e., 18 to 29 weeks.

• It is the early stage of placental maturation.

• The chorionic plate is a well-defined unbroken line which may have fine undulations.

• The placental substance contains a few echogenic areas that are randomly scattered.

Grade 2:

• Gestational age: Late third trimester, i.e., beyond 30 weeks.

• The chorionic plate has more marked indentations.

• The placental substance is incompletely divided with linear echogenic densities.

• Larger calcifications are present in the basilar plate with a ‘dot-dash’ configuration.

Grade 3:

• Gestational age: Beyond 39 weeks, i.e., when the placenta is mature.

• The chorionic plate has complete indentations.

• The placental substance is divided into compartments that demarcate the cotyledons.

• The basal layer is denser and bigger.

Calcification, as above, is considered normal and healthy. However, there is a chance of premature calcification in case of pre-existing maternal health conditions such as placenta previa, high blood pressure, diabetes, or anemiaⁱA condition wherein the body lacks sufficient healthy red blood cells for adequate oxygen transport . Calcification will not affect fetal development in any way.

Next, we answer some frequently asked questions about the anterior placenta.

Infographic: Anterior Placenta: Possible Consequences During Pregnancy And Delivery

An anterior placenta may not cause harm to pregnancy but may increase the risk of certain health conditions. Browse through the infographic to learn about the possible adverse consequences of the anterior placenta during pregnancy and childbirth. You may save and share it with other expecting women.

Illustration: Momjunction Design Team

Illustration: Anterior Placenta: What It Means Effects And Home Care Tips

Image: Dall·E/MomJunction Design Team

Learn about the benefits of an anterior placenta, including improved blood flow to the baby and a smoother delivery.

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Reviewer Author Editor Fact Checker

Dr. Naylin AppannaMD

Dr. Naylin Appanna has over 26 years of experience as a general gynecologist with specialist training in advanced laparoscopic surgery. He specializes in  laparoscopic hysterectomies and laparoscopic pelvic floor reconstruction.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

Read full bio of Rebecca Malachi

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

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Aneesha AmonzMSc

Aneesha holds a Bachelor's degree in Biotechnology from USTM, Meghalaya and Master’s degree in Applied Microbiology from VIT, Vellore. With two years of experience, she has worked on different research projects in the field of Food Sciences.

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