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Placenta Previa and Low-Lying Placenta

Author: Dr. Vasantha K S - Pregnancy and Trying to conceive  

The placenta is a special organ that develops in the uterus only during pregnancy providing nutrition and oxygen to the growing fetus and assisting with the elimination of waste products via the umbilical cord connection.

It is usually located near the top portion of the uterus. If there is placenta previa, it means the placenta is lying lower in the uterus probably blocking the passage of the baby's arrival (cervix).

Types

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

  1. Partial placenta previa (minor).
  2. Complete placenta previa (major).

Low-lying placenta

In this case, the placenta still lies in the lower segment of the uterus, but the edge of the placenta is within 2 cm of the cervix and not covering the os.

Symptoms

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

But, in those whom it is still detected at later stages or still persists in the third trimester, it is less likely to migrate upwards any longer. Then, the delivery will be required to be done via a cesarian 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 called for during this pregnancy.

Precautions

  • Abstinence from sex.
  • Reduce stress.
  • Avoid traveling and bumpy roads.
  • No vaginal examination.
  • No vigorous exercises or jumping.

Risk

The following factors increase the risk of having placenta previa:

  • Previous history of placenta previa.
  • History of a cesarian section.
  • Other uterine surgeries.
  • Carrying multiple fetuses (twins or more).
  • Smoking.
  • Substance abuse.

Causes

  1. Uterine scarring during previous cesarian 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 in a high altitude, the placenta grows larger to compensate for lost functions, and this causes placenta previa.

Complications

For mother: Bleeding during labor and after delivery.

For baby: Growth restriction, premature birth, death.

When to Call the Doctor?

If you have painless bright red bleeding or spotting during the course of 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 be applicable to you.

For more information consult a childbirth educator online --> https://www.icliniq.com/ask-a-doctor-online/childbirth-educator

Image: Placenta Previa and Low-Lying Placenta Last reviewed at: 07.Sep.2018

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