Placenta Previa

Placenta previa is a pregnancy complication where the placenta, a temporary organ that nourishes the baby, grows in a way that partially or completely blocks the opening of the mother's uterus (the cervix). This can be a serious issue because it can prevent the baby from being born vaginally.

A key sign of placenta previa is vaginal bleeding that's bright red and usually painless, happening after the 20th week of pregnancy. Sometimes, there's light bleeding (spotting) before a heavier episode of bleeding.

This bleeding can sometimes be connected to contractions of the uterus, which can cause pain. Sexual activity or a medical exam can also sometimes trigger the bleeding. In some cases, the bleeding might not happen until labor begins. And sometimes, there's no obvious cause or trigger for the bleeding.

If you experience vaginal bleeding during your second or third trimester of pregnancy, contact your doctor immediately. This is important because bleeding during this time can sometimes be a sign of a problem. Don't wait; call your doctor's office right away. If the bleeding is heavy or accompanied by pain, go to the nearest emergency room. This is crucial for your health and the health of your baby.

We don't know exactly why placenta previa happens.

Placenta previa, a condition where the placenta grows in the wrong place in the uterus, is more likely to happen in some women than others. Here are some factors that increase the risk:

• Having previously given birth: Carrying a baby before increases the chances of placenta previa. The uterus, the organ that holds the baby, has to stretch and change during pregnancy and delivery, and this process can sometimes affect where the placenta settles.

• Previous C-sections: A C-section is a surgical delivery. Having one or more C-sections can leave scars on the uterus. These scars can sometimes make it more likely for the placenta to attach abnormally.

• Previous uterine surgeries or procedures: Any surgery involving the uterus, such as a procedure to remove fibroids or polyps, can create scar tissue. This scar tissue can potentially affect the positioning of the placenta.

• History of placenta previa: If a woman has had placenta previa in a past pregnancy, she has a higher chance of experiencing it again.

• Assisted reproductive technology (ART): Procedures like in-vitro fertilization (IVF) can sometimes increase the risk of certain pregnancy complications, including placenta previa. This might be due to the changes in the uterus related to the procedures.

• Multiple pregnancies (twins, triplets, etc.): Carrying more than one baby at a time can make placenta previa more likely. The increased size and demands of the pregnancy can contribute to the issue.

• Age: The risk of placenta previa tends to increase as women get older, with 35 and above being a significant factor. This is likely due to the cumulative changes in the uterus and overall health status over time.

• Smoking: Smoking during pregnancy, or in the past, is linked to an increased chance of placenta previa. The harmful chemicals in cigarettes can affect the uterus and blood vessels.

• Cocaine use: Cocaine use, particularly during pregnancy, can also impact the health of the mother and the developing baby. This includes increasing the risk of placenta previa. Cocaine use can lead to blood vessel damage, impacting placental development and placement.

If you have placenta previa, your doctor will closely watch you and your baby to prevent serious problems.

• Bleeding: A major, potentially life-threatening, blood loss (hemorrhage) from your vagina could happen during pregnancy, labor, delivery, or even in the hours right after giving birth. This bleeding can be severe.

• Early Delivery: If bleeding is severe, your doctor might need to perform a C-section (a surgical delivery) before your baby is fully developed. This is done to protect both you and your baby.

• Placenta Problems: Placenta previa is linked to a group of conditions called placenta accreta spectrum. In these conditions, the placenta grows abnormally deep into or through the wall of your uterus. This can cause a lot of bleeding during pregnancy, labor, delivery, or afterward. It's important to remember that these problems are more likely to happen with placenta previa.

Placenta previa is a condition where the placenta grows in the lower part of the uterus, potentially blocking the birth canal. Doctors typically find it during a pregnancy ultrasound.

Doctors often discover placenta previa during a routine ultrasound scan in the middle of pregnancy. Sometimes, bleeding during pregnancy can also lead to a diagnosis.

The ultrasound is usually done by placing a device on your belly. For a clearer picture, a thinner device might be inserted into your vagina (a transvaginal ultrasound). The healthcare provider will be careful to position this device correctly to avoid disturbing the placenta and causing any bleeding.

Placenta Previa: Understanding the Condition and Treatment

If a routine exam reveals placenta previa, your doctor will likely schedule more frequent ultrasound scans to monitor the placenta's position. This is important because the position of the placenta, in relation to the cervix (the opening to the uterus), can change.

In many pregnancies, the placenta shifts position as the uterus grows. This means the distance between the placenta and the cervix may increase, the placenta may move higher in the uterus, and the part of the placenta near the cervix might shrink. In these cases, the condition often resolves on its own.

If the placenta previa resolves, you may be able to deliver vaginally. If it doesn't resolve, a cesarean section (C-section) will be planned.

Any vaginal bleeding after 20 weeks of pregnancy is considered a medical emergency. You'll likely be admitted to the hospital's labor and delivery unit. You and your baby will be closely monitored, and you might need a blood transfusion if you lose blood.

If you're pregnant for 36 weeks or more, a C-section is usually scheduled to deliver the baby. If you experience significant blood loss or if there's a risk to your or your baby's health, a C-section might be needed sooner.

If this is your first episode of bleeding and it stops for at least 48 hours, you may go home. However, if you experience more episodes of heavy bleeding, you'll likely need to stay in the hospital.

When there's no bleeding, the goal is to prevent future bleeding and prepare for delivery as close to your due date as possible. To do this, you'll likely be advised to avoid:

• Sexual activity: This includes any activity that could lead to orgasm.
• Strenuous exercise: Avoid activities that are intense or exert a lot of effort.
• Heavy lifting: Refrain from lifting anything heavy.
• Prolonged standing: Try to avoid standing for long periods of time.

If you are sent home after your first episode of bleeding, you'll need to follow these guidelines to help prevent further issues.

You should seek immediate medical attention for any vaginal bleeding or contractions. Your doctor might ask about your support system at home, to ensure you have a way to get to the hospital quickly if needed.

Even if you haven't experienced any bleeding due to placenta previa, or if the bleeding has stopped, a scheduled C-section is typically planned sometime between weeks 36 and 37. If your delivery is scheduled before 37 weeks, your doctor may recommend corticosteroids to help your baby's lungs develop.