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PLACENTA PREVIA

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PLACENTA PREVIA

Placenta previa is a condition that occurs when a baby’s placenta attaches inside the uterus but totally or partially covers the mother’s cervical opening.

  • The placenta is a structure that develops in the uterus during pregnancy. This structure allows nutrient uptake, provides oxygen to the growing baby and eliminates waste product from the baby’s blood.
  • In most pregnancies, the placenta attaches to the top of the uterus or at the side of the uterus. This position allows the cervix a clear path for delivery
  • Placenta previa can cause severe bleeding during pregnancy and at the time of delivery. This occurs because the placenta is rich in blood vessels.

    There are three types of placenta previa:

  • COMPLETE which occurs when the cervix is completely covered by the placenta
  • PARTIAL which occurs when the cervix is partially covered by the placenta
  • MARGINAL which occurs when the placenta is located adjacent to, but not covering, the cervical opening.

CAUSES

The exact cause of placenta previa is unknown. However, some risk factors are associated with the development of placenta previa including:

  • Previous miscarriage
  • Use cocaine
  • Unusual position of the baby
  • Smoking
  • Maternal age of 35 or older
  • Have scars from previous surgery involving the uterus such as caesarian deliveries, uterine fibroid removal, dilation and curettage
  • Previous abortion
  • Previous placenta previa
  • Large placenta
  • Being pregnant with twins or multiples
  • Being Asian and African

SYMPTOMS

  • Painless, bright red bleeding during the second half of pregnancy
  • Some women have contractions
  • Bleeding that starts mildly, stops, and begins again days or week later

DIAGNOSIS AND TREATMENT

Placenta Previa is diagnosed through ultrasound either after an episode of bleeding or during a routine prenatal appointment.

The doctors will monitor the position of the placenta using either a transabdominal ultrasound and transvaginal ultrasound or a combination of both

Transvaginal ultrasound involves placing a wand-like a device into the vagina but away from the cervical opening to provide a visual view of the vaginal canal and cervix.

Transabdominal ultrasound involves the use of a gel on your abdomen after which the doctor moves a handheld unit called a transducer around it to visualize the abdomen.

If placenta previa is suspected, the doctor may avoid pelvic exam to reduce the risk of further bleeding

TREATMENT

There exist no medical or surgical treatment for placenta previa but several options are available to manage the bleeding caused by the condition.

Doctors will decide how to treat your placenta previa based on:

  • The amount of bleeding
  • Your health
  • The baby’s health
  • The position of the baby and the placenta
  • How far along the pregnancy is
For little or no bleeding

The health care provider will suggest bed rest. This means restraining form activities that can trigger bleeding such as sex, exercises. If bleeding occurs during the period of best rest, emergency medical care should be sought.

For heavy bleeding

Immediate medical attention at the nearest emergency health facility may be required for heavy bleeding. If the amount of lost blood is much, you may need blood transfusion as well as take medication to prevent premature birth. A C-section is advised as soon as delivery is safe usually after 36 weeks of pregnancy. If bleeding persists, early delivery through C-section may be the best option. The baby is given corticosteroids to help and speed up lung growths.

Uncontrolled bleeding

in the case of a bleeding that won’t stop, an emergency C-section delivery may be suggested even if the baby is premature.