Learn what to watch for and what to expect if you have placenta previa, a potentially dangerous pregnancy complication.
The placenta is a structure that develops inside your uterus during pregnancy, providing oxygen and nutrition to and removing wastes from your baby. The placenta connects to your baby through the umbilical cord. In most pregnancies, the placenta attaches at the top or side of the uterus.
Placenta previa (pluh-SEN-tuh PREH-vee-uh) occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery.
If you have placenta previa, you might bleed throughout your pregnancy and during your delivery. Your health care provider will recommend avoiding activities that might cause contractions, including having sex, douching, using tampons, or engaging in activities that can increase your risk of bleeding, such as running, squatting, and jumping.
You'll need a C-section to deliver your baby if the placenta previa doesn't resolve.
Bright red vaginal bleeding without pain during the second half of pregnancy is the main sign of placenta previa. Some women also have contractions.
In many women diagnosed with placenta previa early in their pregnancies, the placenta previa resolves. As the uterus grows, it might increase the distance between the cervix and the placenta. The more the placenta covers the cervix and the later in the pregnancy that it remains over the cervix, the less likely it is to resolve.
If you have vaginal bleeding during your second or third trimester, call your doctor right away. If the bleeding is severe, seek emergency medical care.
The exact cause of placenta previa is unknown.
Placenta previa is more common among women who:
If you have placenta previa, your health care provider will monitor you and your baby to reduce the risk of these serious complications:
Placenta previa is diagnosed through ultrasound, either during a routine prenatal appointment or after an episode of vaginal bleeding. Most cases of placenta previa are diagnosed during a second trimester ultrasound exam.
Diagnosis might require a combination of abdominal ultrasound and transvaginal ultrasound, which is done with a wandlike device placed inside your vagina. Your health care provider will take care with the position of the transducer in your vagina so as not to disrupt the placenta or cause bleeding.
If your health care provider suspects placenta previa, he or she will avoid routine vaginal exams to reduce the risk of heavy bleeding. You might need additional ultrasounds to check the location of your placenta during your pregnancy to see if placenta previa resolves.
There is no medical or surgical treatment to cure placenta previa, but there are several options to manage the bleeding caused by placenta previa.
Management of the bleeding depends on various factors, including:
If placenta previa doesn't resolve during your pregnancy, the goal of treatment is to help you get as close to your due date as possible. Almost all women with unresolved placenta previa require a cesarean delivery.
Your health care provider might recommend rest, which means avoiding activities that can trigger bleeding, such as sex and exercise.
Be prepared to seek emergency medical care if you begin to bleed. You'll need to be able to get to the hospital quickly if bleeding resumes or gets heavier.
If the placenta is low lying but doesn't cover the cervix, you might be able to have a vaginal delivery. Your health care provider will discuss this option with you.
Heavy bleeding requires immediate medical attention at your nearest emergency health facility. Severe bleeding might require a blood transfusion.
Your health care provider will likely plan a C-section as soon as the baby can be delivered safely, ideally after 36 weeks of pregnancy. However, you might need to have an earlier delivery if heavy bleeding persists or if you have multiple bleeding episodes.
If your delivery is planned before 37 weeks, your doctor will offer you corticosteroids to help your baby's lungs develop.
If your bleeding can't be controlled or your baby is in distress, you'll likely need an emergency C-section — even if the baby is premature.
If you're diagnosed with placenta previa, you're sure to worry about how your condition will affect you, your baby and your family. Some of these strategies might help you cope:
If you've been pregnant for more than 12 weeks and you develop vaginal bleeding, call your pregnancy health care provider. He or she may recommend immediate medical care, depending on your symptoms, your medical history and how far along you are in the pregnancy.
Before your appointment, you may want to:
Basic questions about placenta previa to ask your health care provider include:
Don't hesitate to ask other questions.
Your health care provider is likely to ask you a number of questions, including:
December 24th, 2020