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Placenta Previa: What Is It and What to Do?

Childbirth is beautiful. However, sometimes, it may present certain conditions which can create complications, not only for the mother but also for the baby. One such condition is placenta previa. In this article, we will see the meaning of placenta previa, how it occurs, signs and symptoms; and treatment of the same

What is Placenta Previa?

The placenta develops, alongside the baby in the uterus, during pregnancy. In a normal situation, the placenta, which provides oxygen and nutrition to the unborn baby, is positioned away from the cervix. However, due to some reasons, it may also move to a position that either partially or fully covers the cervix. This condition is called placenta previa and is one of the complications that can affect pregnant women during the initial days of pregnancy. This abnormal positioning of the placenta can cause mild to heavy vaginal bleeding, which may be painless, and can occur during a routine vaginal inspection.

What Causes Placenta Previa?

The exact cause of placenta previa is not known. However, there are some factors that are believed to contribute to the cause of placenta previa which are stated further below. Even after taking every bit of precaution, there will always be a chance of this condition occurring. However, knowing the few causes which greatly increase the chances, and taking adequate preventive measures, is always recommended.

I) Pregnancy at an older age

II)  Smoking

III) Use of cocaine

IV) Curettage or presence of uterine scars from a previous termination. This could also be caused by uterine fibroid removal.

V) Previous pregnancies, especially a previous C-section

VI) Previous miscarriages

VII) Pregnancy with more than one fetus, in which case there is more space for the placenta to move than normal

VIII) There has been a perceived higher occurrence of the condition in people of color.

IX) The unusual position of the baby, either in a breech position (buttocks first) or transverse position (lying horizontally across the womb).

X) Development of a larger than usual placenta

Signs and Symptoms of Placenta Previa

There is a range of symptoms caused by this condition, depending upon the period of gestation.

Women, generally in the second half of their pregnancy, or around the twentieth week, may experience painless bleeding, which is bright red in colour. There is no definite trigger for it as it can start by itself, or in some cases, after sex. The flow may be lighter or heavy. In the worst-case scenario, this can cause hemorrhage. Additionally, there can be a feeling of tightening and cramping during the bleeding which can create pressure on the back.

If not properly treated, the condition can take a turn for the worse, and the haemorrhage due to heavy bleeding can pose a threat to the mother. This may happen during labour, or in the first few hours after delivery. In some cases, where the bleeding is severe, the doctor or midwife may decide to follow a C-Section, rather than a natural delivery, to minimize the risk to the mother.

Diagnosis of Placenta Previa

If you see any bleeding and are doubtful of placenta previa, you should instantly get medical expert assistance on the matter. At first, the type of placenta previa has to be properly inspected and diagnosed. If the condition is diagnosed, there are ways to ensure the safety of the mother and the safe birth of the baby. Most signs show up during routine ultrasound scan done during the twentieth week. At this stage, there is always a chance that the placenta may correct its position. According to research done by the Royal College of Obstetricians and Gynaecologists, only ten percent of these cases actually go on to become full placenta previa. Once the type is identified, follow up tests and scans will be done through different methods, as determined by the doctor:

1. In case of a transvaginal ultrasound, a probe may be placed gently inside the vagina to obtain an inside view of the vaginal canal and cervix.

2. Sometimes, a trans-abdominal ultrasound can be carried out, in which a gel is placed on or around the abdomen to get a view of the pelvic organs.

3. The most accurate method, however, is the use of MRI (Magnetic Resonance Imaging) which gives the correct location of the placenta.

Stages of Placenta Previa

Depending upon the said location of the placenta, the cases can divide into four stages – Partial, Low lying, Marginal and Complete Previa.

a. In case of a Partial Previa, the placenta is partially covering the opening of the cervix. In this case, vaginal birth can be allowed.

b. A Low Lying Previa may happen during the middle of the pregnancy, with the placenta at the edge of the cervix. There can still be a possibility of vaginal birth.

c. In some cases, the placenta begins to grow at the bottom of the uterus, and will push against the cervix, but may not cover it. This is called Marginal Previa. Minor bleeding can occur during labour as the placenta may be touching the internal opening of the cervix. However, a vaginal birth is generally considered safe in this condition.

d. A more serious problem may arise, when the placenta completely covers the entire cervix. This is called Complete Previa. In this situation, the baby has to be delivered through a C-section, and prematurely, if still within gestation period.

Treatment of Placenta Previa

The treatment for placenta previa also depends on other factors such as the amount of bleeding, the month of pregnancy, as well as the health of the baby. Most of the time, the treatment centers around the amount and flow of bleeding.

In the case of minimal to no bleeding, complete bed rest is advised with sitting and standing allowed only if necessary. Sex and exercise have to be avoided as well. Immediate medical attention should be provided in case of any bleeding. Thus, it is always advised to be within close distance to a hospital or nursing home, which is better equipped with the infrastructure and personnel for this kind of situation.

If the mother is experiencing heavy bleeding, she should be admitted to the hospital as soon as possible, and kept under observation. In case of blood loss which may cause anemia, blood transfusion and adequate iron supplements should be provided to her. To avoid preterm labour, medicines may be prescribed. If the bleeding is uncontrollable, an emergency C-Section may be recommended.

There is a valid reason why expecting mothers may be worried about the symptoms of placenta previa. This is why their partners and other family members should have proper knowledge about the condition and must be ready to take the best recourse necessary for the safety of the mother and the baby. So hope this article helps you. If it did, do share the article around wherever possible.

Written by Bhargavi J