Placenta Previa

Placenta previa is a condition in pregnancy. It occurs when the placenta develops in the lower part of the womb and covers the opening of the cervix partially or entirely. It is a serious problem in pregnancy. It can lead to severe bleeding during pregnancy and at the time of delivery. 

The placenta develops at the time of pregnancy. It is the lining inside the uterus. It provides oxygen and nutrition to the fetus and eliminates waste.

Roughly 75% of women with placenta previa in their third trimester have planned C-section deliveries. Women with marginal placenta previa can deliver vaginally with close monitoring, but almost all women with complete placenta previa require a cesarean delivery. They are also at higher risk of delivering prematurely. In many cases, the placenta previa resolves with time because when the uterus grows, the distance between the placenta and cervix increases. However, the larger the placenta, the more it will cover the cervix and the lesser the chances of its automatic resolution.

 

1. Placenta previa is a condition in pregnancy. It occurs when the placenta develops in the lower part of the womb and covers the opening of the cervix partially or entirely. It is a serious problem in pregnancy. It can lead to severe bleeding during pregnancy and at the time of delivery. 
2. The placenta develops at the time of pregnancy. It is the lining inside the uterus. It provides oxygen and nutrition to the fetus and eliminates waste.
3. Roughly 75% of women with placenta previa in their third trimester have planned C-section deliveries. Women with marginal placenta previa can deliver vaginally with close monitoring, but almost all women with complete placenta previa require a cesarean delivery. They are also at higher risk of delivering prematurely. In many cases, the placenta previa resolves with time because when the uterus grows, the distance between the placenta and cervix increases. However, the larger the placenta, the more it will cover the cervix and the lesser the chances of its automatic resolution.

 

Cause of Placenta Previa

1. The placenta is the connection between the baby and the mother. The exact cause of placenta previa is still unknown. However, several conditions increase the risk of placenta previa, such as:
2. Abnormally shaped uterus
3.  
4. Having more than one fetus 
5. The unusual position of the baby
6. Prior case of miscarriage
7. If the mother is 35 years or more
8. Had multiple pregnancies in the past
9. If the placenta is large
10. Had a case of placenta previa with a previous pregnancy
11. Had a habit of smoking
12. Use drugs or cocaine
13. Having a baby through In vitro fertilisation (IVF)
14. Have a scar on the uterus due to past surgery, C-section, dilation, and curettage (D&C), or abortion
15. Had a uterine fibroid or cyst removal

Cause of Placenta Previa

1. The placenta is the connection between the baby and the mother. The exact cause of placenta previa is still unknown. However, several conditions increase the risk of placenta previa, such as:
2. Abnormally shaped uterus
3. Having more than one fetus 
4. The unusual position of the baby
5. Prior case of miscarriage
6. If the mother is 35 years or more
7. Had multiple pregnancies in the past
8. If the placenta is large
9. Had a case of placenta previa with a previous pregnancy
10. Had a habit of smoking
11. Use drugs or cocaine
12. Having a baby through In vitro fertilisation (IVF)
13. Have a scar on the uterus due to past surgery, C-section, dilation, and curettage (D&C), or abortion
14. Had a uterine fibroid or cyst removal

Signs and Symptoms

Almost one-third of pregnant women with placenta previa have no symptoms. The doctor diagnoses the condition during the follow-up of the ultrasound test. The symptoms of placenta previa are:

Painless vaginal bleeding, especially during the second trimester or at the beginning of the third trimester

Contractions and bleeding may also lead to abdominal and lower back pain.

Signs and Symptoms

Almost one-third of pregnant women with placenta previa have no symptoms.

The doctor diagnoses the condition during the follow-up of the ultrasound test. The symptoms of placenta previa are:

1. Painless vaginal bleeding, especially during the second trimester or at the beginning of the third trimester
2. Contractions and bleeding may also lead to abdominal and lower back pain.

Diagnosis of Placenta Previa

The placenta previa is diagnosed by ultrasound. The ultrasound uses sound waves to create images of the internal organ of the body. It can be diagnosed either at routine prenatal check-ups or after an episode of vaginal bleeding. When there is no bleeding, the placenta previa is generally diagnosed in the 2nd or 3rd trimester. If there is vaginal bleeding, the doctor will ask for other signs that can confirm the placenta previa. The diagnosis is confirmed by both abdominal ultrasound and transvaginal ultrasound.

The placenta position is diagnosed using one of the following methods:

Transvaginal ultrasound: The doctor inserts a probe inside the vagina in this procedure. It produces an internal view of the vagina canal and cervix. It is one of the accurate methods to confirm placenta previa.

 Transabdominal ultrasound: The doctor applies a gel on the mother's abdomen in this method. Then a handled unit called a transducer is moved around the stomach. It helps to look at the inside of the pelvic organs. The sound waves from the transducer develop an image on the monitor.

MRI (Magnetic Resonance Imagining): It uses magnetic waves to produce the image of the inside of the body. MRI helps to locate the position of the placenta.

TREATMENT1,13

There is no surgical or medical cure for the placenta previa. The treatment of placenta previa mainly aims to complete the 36 weeks of pregnancy and minimise the symptoms of previa. If placenta previa does not resolve during pregnancy, the goal of the treatment is to reach the end of the gestation period by limiting the risk of bleeding.

The Management of placenta previa bleeding depends on different factors such as:

Position of placenta and fetus

Severity and extent of bleeding (heavy or light)

If the fetus develop enough to survive outside the womb

Area covered by the placenta in the cervix 

The health of the baby and mother

Condition of the fetus

Week of the pregnancy

Whether bleeding has stopped or not

Some of the management options include:

For Little or No Bleeding: The doctor will recommend you rest and ask you to avoid any sexual activity and exercise. The doctor may proceed with vaginal delivery if the placenta is low lying and does not cover the cervix later in pregnancy.

For Heavy Bleeding: It requires immediate medical attention. The doctor will admit you to the hospital. You might need a blood transfusion in case you have had severe bleeding. In this, the doctor will plan for C-section, keeping in mind that you have completed the 36 weeks of pregnancy. The doctor will prescribe some corticosteroids. It helps in the development of the baby's lungs. The doctor may prescribe you the medication that slows down or inhibits premature labour pains. These drugs include tocolytic drugs, terbutaline, or magnesium sulfate. Once the doctor feels the baby can be safely delivered (after 36 weeks), they will proceed with a C-section operation.

For Non-Stop Bleeding: If the bleeding is not stopping, even after the treatment in hospital, the doctor will go for an emergency C-section, even if the baby is premature. 

Cause and Risk factors of Placenta Previa

1. The placenta is the connection between the baby and the mother. The exact cause of placenta previa is still unknown. However, several conditions increase the risk of placenta previa, such as:
2. Abnormally shaped uterus

 

1. Having more than one fetus 
2. The unusual position of the baby
3. Prior case of miscarriage
4. If the mother is 35 years or more
5. Had multiple pregnancies in the past
6. If the placenta is large
7. Had a case of placenta previa with a previous pregnancy
8. Had a habit of smoking
9. Use drugs or cocaine
10. Having a baby through In vitro fertilisation (IVF)
11. Have a scar on the uterus due to past surgery, C-section, dilation, and curettage (D&C), or abortion
12. Had a uterine fibroid or cyst removal

Cause and Risk factors of Placenta Previa

1. The placenta is the connection between the baby and the mother. The exact cause of placenta previa is still unknown. However, several conditions increase the risk of placenta previa, such as:
2. Abnormally shaped uterus
3. Having more than one fetus 
4. The unusual position of the baby
5. Prior case of miscarriage
6. If the mother is 35 years or more
7. Had multiple pregnancies in the past
8. If the placenta is large
9. Had a case of placenta previa with a previous pregnancy
10. Had a habit of smoking
11. Use drugs or cocaine
12. Having a baby through In vitro fertilisation (IVF)
13. Have a scar on the uterus due to past surgery, C-section, dilation, and curettage (D&C), or abortion
14. Had a uterine fibroid or cyst removal