Placenta previa, also known as low lying placenta, is a pregnancy complication, occurs when the placenta covers part or all of the cervix during the last months of pregnancy. It can cause severe bleeding before or during labor.
The placenta is a structure that develops inside the uterus during pregnancy, providing oxygen and nutrition to and removing wastes from the baby. The placenta connects to baby through the umbilical cord. The placenta is also referred to as “afterbirth” because it exits the body after the baby is born.
During pregnancy, the placenta moves as the uterus stretches and grows.It is normal for the placenta to be low lying in the uterus in early pregnancy.
As the pregnancy continues and the uterus stretches, the placenta itself moves to the top of the uterus. By the third trimester, the placenta should be near the top of the womb. This position allows the cervix, a clear path for delivery.
• Marginal –
The placenta is next to the cervix but does not cover the opening
• Partial –
The placenta covers part of the cervical opening
• Complete –
The placenta covers all of the cervical opening
Main sign of placenta previa-
Bright red light to heavy vaginal bleeding without pain
Other important symptoms which needs immediate medical attention includes-
• Cramps or sharp pains
• Bleeding during the second half of pregnancy
• Bleeding after intercourse
• On and off bleeding with days or weeks internal
The exact cause of placenta previa is still unknown.
Risk Factors –
This condition is more common among women who –
• Have scars on the uterus such as from previous surgery, including cesarean deliveries, uterine fibroid removal and dilation and curettage
• Had placenta previa in previous pregnancy
• Are carrying more than one fetus
• Are age 35 or older
• Use cocaine
• Have unusual position of the baby – breech or transverse
• Had previous miscarriage
• Have abnormal shaped uterus
• Have large placenta
• Have already given birth to one child
Here are the risk of complications that may occur due to this crucial condition-
• Bleeding –
Severe, possibly life threatening vaginal bleeding can occur during labor, delivery or in the first few hours after delivery
• Preterm birth-
Severe bleeding may prompt an emergency C-section before your baby is full term.
Usually, the first sign of this condition appear during 20 week ultrasound scan. These initial signs are not ne cessarily a cause for worry, since the placenta is often lower in the uterus during the early part of a woman’s pregnancy.
For any sign & symptom of this complicated condition, doctor will monitor the position of the placenta using following techniques –
• Transvaginal Ultrasound
• Transabdominal Ultrasound
• Magnetic Resonance Imaging (MRI)
There is no medical or surgical treatment to cure placenta previa, but there are severed options to manage the bleeding caused in this condition.
Management of bleeding depends on various factors, which includes –
• The amount of bleeding
• Whether the bleeding has stopped
• How far along your pregnancy is
• Your health
• Your baby’s health
• The position of the placenta and the baby
If the condition doesn’t resolve during pregnancy, the goal of treatment is to help to get as close to due date as possible. Almost all women with unresolved placenta previa require a cesarean delivery.
For little or no bleeding
Your doctor might recommend bed rest to you, which means resting in bed as much as possible, and only standing and sitting when absolutely necessary. It also involves avoiding activities that can trigger bleeding such as sex and exercise.
For heavy bleeding
Cases of heavy bleeding may require hospital bed rest. Depending on the amount of blood lost, You may need blood transfusions. Medicines to prevent premature labor also needed.
If the caesarean section needs to be scheduled sooner than 36 weeks, your baby may be given corticosteroid injections to speed up his or her lung growth.
For bleeding that won’tstop
In case of uncontrolled bleeding, an emergency cesarean delivery will have to be done.
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