Placenta Previa and Low-Lying Placenta

What Is Placenta Previa?

Placenta Previa is the abnormal positioning of the placenta in the uterus. The placenta is an exclusive organ that uniquely grows in the uterus only during pregnancy. People can take a home pregnancy test to determine if they are pregnant. It serves as the source of the young child's nutrition and oxygen and also helps get rid of the baby's waste products through its cord. The child is connected to the placenta via his umbilical cord. Mainly, it is situated at the highest levels of the uterus. The placenta also relocates as the uterus gets longer and larger during the course of pregnancy.

Usually, during the early period of pregnancy, the placenta is positioned low down in the uterus. But by the time the pregnancy has reached its third trimester, the placenta, if possible, should be up near the top of the uterus. This leaves the birth canal free for the baby to come out without being blocked by any other material.

Placenta Previa is a condition in which the placenta is located low in the uterus, thus blocking the baby's way of coming out through the cervix. This irregular position of the placenta can be accompanied by tremendous bleeding during the entire pregnancy and delivery process as well. Females with this pertaining to one must avoid extreme activities, such as sexual intercourse, douching, using tampons, running, and jumping. An operation to get the baby out can be the last resort if the condition does not improve.

What Are the Types of Placenta Previa?

A placenta previa can either cover the cervix partially or totally. So, depending on that, we have two types:

1. Partial Placenta Previa (Minor) - The placenta covers only part of the cervical opening.

2. Low-Lying Placenta Previa - The placenta is positioned at the edge of the cervix and does not cover the opening.

3. Complete Placenta Previa (Major) - The placenta covers the entire cervical opening.

4. Marginal Placenta Previa - In this case, the placenta lies in the lower segment of the uterus and presses the cervix. The edge of the placenta is within 2 cm of the cervix and not covering the opening.

What Are the Signs and Symptoms of Placenta Previa?

Bright red, painless vaginal bleeding in the second or third trimester is a sign to suspect placenta previa. The other symptoms include sharp cramps, abdominal pain, and bleeding after sex. In most women detected with placenta previa during early pregnancy, the placenta migrates upwards (due to the growth of the uterus), and the condition resolves independently. After a few weeks, the doctor may order a scan to recheck the location.

But, in those still detected at later stages or persist in the third trimester, it is less likely to migrate upwards. Then, the delivery will be required to be done via a cesarean section.

Whereas, in minor (partial) cases, vaginal delivery may be attempted if deemed suitable by the attending doctor. Irrespective of a major or minor one, some precautions are necessary during this pregnancy.

When to Call the Doctor?

If you have painless, bright red bleeding or spotting during your pregnancy, it is critical to be at the hospital at the earliest. In case of severe bleeding, it can be life-threatening, and you may require blood transfusions. Also, consult the doctor for any other specific restrictions that may apply to you.

What Causes Placenta Previa?

The possible causes include:

1. Uterine scarring during previous cesarean section delivery, D and C procedures, or any other surgery involving the uterus.

2. When the functional capacity of the placenta is lowered due to multiple gestations, smoking mother, or living at a high altitude, the placenta grows larger to compensate for lost functions, and this causes placenta previa.

Risk Factors:

The following factors increase the risk of having placenta previa:

1. Breech (baby's buttock is positioned to be delivered first) or transversely positioned baby (baby lies horizontally across the womb).

2. The uterus is shaped abnormally.

3. Multiple pregnancies.

4. History of a miscarriage.

5. She advanced maternal age.

6. Smoking.

7. Other uterine surgeries include cesarean delivery and dilation and curettage (D&C).

8. Abnormally large placenta.

9. Substance abuse.

10. Previous history of placenta previa.

How Does a Doctor Diagnose Placenta Previa?

This condition is usually diagnosed during a routine ultrasound at 20 weeks. But it is nothing to worry about, as the placenta, in most cases, is positioned lower during early pregnancy. As the weeks go by, the placenta generally corrects itself. Only 10 % of cases will lead to significant placenta previa (according to the Royal College of Obstetricians and Gynecologists).

If you notice painless bleeding during the second half of your pregnancy, consult a doctor, who will detect the position of the placenta using the following methods:

1. Transvaginal Ultrasound- A transducer is placed inside the vagina, which provides images of the inside of the uterus and cervix. This diagnosis of placenta previa is the most accurate.

2. MRI (Magnetic Resonance Imaging)- Thisgives detailed images of the placenta's location.

How Is Placenta Previa Treated?

Depending on how much bleeding is occurring, the baby's health, the position of the baby and placenta, and how far along you are, the doctor will form a treatment plan. The doctor usually monitors the amount of bleeding before treating the condition.

No to Minimal Vaginal Bleeding:

• Bed rest as much as possible.

• Standing and sitting only when necessary.

• Abstinence from sex.

• Reduce stress.

• Avoid traveling and bumpy roads.

• No vaginal examination.

• No vigorous exercises or jumping.

If you still bleed, then consult your doctor as soon as possible.

Considerable Amount of Vaginal Bleeding:

• This requires hospitalization and bed rest.

• You might need a blood transfusion if you have lost a lot of blood.

• Medicines will be prescribed for premature labour.

Severe Vaginal Bleeding:

If you have severe vaginal bleeding, then the doctor will schedule a C-section as early as possible. It is usually done after 36 weeks. In case the C-section has to be done earlier, then the doctor injects corticosteroid injections to help the baby's lungs mature fast.

Uncontrollable Vaginal Bleeding:

An emergency cesarean delivery is done.

What Are the Complications of Placenta Previa?

• Bleeding during labour and after delivery is the most common complication for mothers.

• In the case of placenta previa, growth restriction, premature birth, and death are seen in babies.

To learn more about the possible complications and treatment options for placenta previa, consult an obstetrician and gynecologist online.

Conclusion -

The low-lying placenta is known as placenta previa. This condition occurs in pregnancy. The low position of the placenta is seen in the uterus, along with the covering of the cervix. This is a complicated condition that could result in bleeding, especially in the third trimester of pregnancy. This condition requires monitoring and birth plan adjustment. Placenta previa cases mostly needed a cesarean delivery. Most cases are resolved by themselves as the pregnancy progresses and the placenta shifts upwards. Medical supervision is important to ensure the mother's and baby's health and safety.