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Pregnancy-related placenta previa is an issue when the entire or partial part of the placenta blocks the uterine opening (cervix).
During pregnancy, an organ called the placenta grows inside the uterus. The function of the placenta is to provide the newborn with nutrition and oxygen as well as removing the fetus’s waste. Your baby and the placenta are linked by the umbilical cord. Normally, the placenta will attach to the top or at either side of the uterus. The condition where the placenta attaches lower in the uterus is called placenta previa. As a result, the cervix is partially covered by placental tissue. It can lead to bleeding during labor, during the pregnancy, or after delivery.
Pregnancy-related alterations to the uterus and placenta may cause the issue to resolve itself. If not, a cesarean section will be chosen to deliver the infant (C-section).
Symptoms
Placenta previa usually present with painless vaginal bleeding after 20 weeks of pregnancy, although bleeding from placenta previa can be associate with contraction that cause pain. Spot bleeding can occasionally occur before a situation involving significant blood loss.
Other factors that can cause bleeding include intercourse and being examined by a doctor.
Call your doctor as soon as you notice vaginal bleeding during second or third trimester. Go to an emergency room if the bleeding is serious.
Causes
The cause of placenta previa is unknown. Your medical history and particular lifestyle choices are a couple of things that could increase the risk of having placenta previa.
Risk factors
The likelihood of placenta previa is higher in women who:
- Have been pregnant before
- Previous uterine scar
- Had a previous pregnancy with placenta previa
- Being 35 years of age or more
- Being pregnant after undergoing a surgery using assisted reproductive technology (ART) to address
- infertility
- History of Caesarian section
- Multiple fetal pregnancy
- Having a uterine fibroid history
- Use cocaine
- Smoke
Diagnosis
When vaginal bleeding occurs or at a regular prenatal visit, placenta previa is identified via ultrasound. The majority of placenta previa cases are identified during a second-trimester ultrasound examination.
- Abdominal ultrasound: This uses a device called a transducer, it will be place on the lower abdomen to produce a sound wave and creates an imaging which helps to determine the position of the baby, the placenta and cervix.
- Transvaginal ultrasound: A tool known as a transducer is used to produce imaging and it will be guided through the vagina to evaluate the position of the baby, the placenta and cervix.
Treatment
If you have placenta previa, you may need more frequent ultrasounds to track the placenta’s movement during pregnancy.
Many women who have been diagnosed with placenta previa in their early antenatal care may see improvement of the condition on its own during late trimester pregnancy since the space between the cervix and the placenta may widen as the uterus expands. The borders of the placental tissue close to the cervix may also contract and the placenta’s growth direction may be higher in the uterus.
You might be able to prepare for a vaginal delivery if placenta previa resolves. You will make plans for a C-section delivery if it does not get better.
Treatment of bleeding
After 20 weeks, vaginal bleeding is handled as a medical emergency. The hospital’s labor and delivery unit might require the patient to admit for close monitoring. You will be observed together with your unborn child, and you might require a blood transfusion to replace lost blood.
If you are 36 weeks pregnant, the baby will probably be delivered via C-section. An emergency C-section may be required before 36 weeks if there is a risk to the health of you or the unborn child, excessive blood loss, or both.
You might be discharged from the hospital if this was your first episode of bleeding, and the bleeding has stopped for at least 48 hours. Your doctor could advise that you stay in the hospital if you continue to experience episodes of severe bleeding.
Treatment with no bleeding
When there is no bleeding, the goal of treatment is to get you as close to your due date as possible while reducing the risk of potential bleeding. You should avoid the following, according to your doctor:
- Sexual activity or interactions that could cause orgasm
- Mild or extreme exercise
- Mild or lifting heavy objects
- Prolonged durations of standing
Following these guidelines is required if you are discharged from the hospital following your first bleeding episode in order to reduce your risk of experiencing another one.
If you experience any contractions or vaginal bleeding, you will be recommended to seek emergency medical attention. If you have support at home that enables transportation to a nearby hospital, your doctor might inquire.
Planned C-section delivery
Even if placenta previa has not cause bleeding throughout your pregnancy or since the initial episode, you’ll probably require a a C-section scheduled for between 36 and 37 weeks.
Your doctor will suggest corticosteroids to you if you are expecting your baby earlier than 37 weeks in order to aid in the development of his or her lungs.
