Skip to content

Placenta Previa: Low Lying Placenta Effects on Baby

placenta previa low lying placenta

Placenta Previa (low lying placenta) is a pregnancy complication that’s on a rise and will continue to do so as a result of rising rates of caesarean deliveries and increased maternal age. Your doctor will look at the scans to determine the position of the placenta in your womb. If the placenta stays low in your womb, near to or covering your cervix, it is called low-lying placenta or placenta previa. In such a case, it may block the baby’s way out. It affects about 1 in every 200 births, but in most cases the cervix is not completely covered.

Research study [1] indicates that high maternal age and prior operations of the uterine cavity are risk factors for placenta previa. Placenta previa is more common if you have had one or more previous caesarean births, if you have had fertility treatment to get pregnant, or if you smoke.

Placenta Previa: Simplified

When the placenta lies low in the uterus, it may partly or completely cover the cervix. This is called placenta previa. It may cause vaginal bleeding. This type of bleeding often occurs without pain. In some cases, low lying placenta will resolve on its own by 32–35 weeks of pregnancy as the lower part of the uterus stretches and thins out. However a low-lying placenta after 20-22 weeks of pregnancy is termed as placenta praevia or placenta accreta depending upon the location of placenta.

If placenta previa resolves itself by third trimester, labor and delivery can happen normally. If placenta previa does not resolve, you may need to have the baby early by cesarean delivery.

Let’s understand the other problems with placenta that may need attention and care in pregnancy.

  • Placental abruption—In placental abruption, the placenta detaches from the wall of the uterus before or during birth. The most common signs and symptoms are vaginal bleeding and abdominal or back pain. Placental abruption can cause serious complications if it is not found early. The baby may not get enough oxygen, and the pregnant woman can lose a large amount of blood.
  • Placenta accreta—When the placenta (or part of the placenta) invades and is inseparable from the uterine wall, it is called placenta accreta. Placenta accreta is a rare (between 1 in 300 and 1 in 2000) complication of pregnancy. It can cause bleeding during the third trimester and severe blood loss during delivery. Most cases can be found during pregnancy with a routine ultrasound exam. Sometimes, though, it is not discovered until after the baby is born. If you have placenta accreta, you are at risk of life-threatening blood loss during delivery. Your ob-gyn will plan your delivery carefully and make sure that all needed resources are available. You may need to have your baby at a hospital that specializes in this complication. Hysterectomy often needs to be done right after delivery to prevent life-threatening blood loss.

Placenta Previa types

There are different forms of placenta previa: low lying placenta types –

  • Marginal: The placenta is next to the cervix but does not cover the opening.
  • Partial: The placenta covers part of the cervical opening.
  • Complete: The placenta covers all of the cervical opening

Placenta Previa: Low lying Placenta Dos and Don’ts

Your doctor will advise you additional care, including whether or not you need to be admitted to hospital, based on your individual circumstances. Even if you have had no symptoms before, there is a small risk that you could bleed suddenly and heavily, which may mean that you need an emergency caesarean.

Ask your doctor for specific instructions for your situation of low lying placenta.

Here is a list of general guidelines alongwith do’s and don’ts for those having placenta previa:

  • Doctors will ensure that digital cervical examination is avoided as it can result in severe hemorrhage.
  • Some research [2] also suggests patients with placenta previa after 20 weeks of gestation (earlier if they have experienced vaginal bleeding) to avoid any sexual activity that may lead to orgasm. Many doctors recommend that women with placenta previa not have intercourse after 28 weeks of pregnancy. 
  • Do not put anything, such as tampons or douches, into your vagina. Use pads if you are bleeding, and call your doctor or visit your hospital.
  • You should try to avoid becoming anemic during pregnancy by having a healthy diet and by taking iron supplements if recommended by your doctor. Your blood haemoglobin levels (a measure of whether you are anemic) will be checked at regular intervals during your pregnancy.
  • Avoid activities that might increase your risk of bleeding, such as running, squatting, and jumping.
  • Women diagnosed with placenta previa after 28 weeks’ gestation are at risk for spontaneous labour and should avoid MVPA (Moderate-to-Vigorous Physical Activity). However, these women should maintain their activities of daily living and low-intensity activity (ie, walking). [3]

Placenta Previa Effects on baby: What are the risks involved?

There is a risk that you may have vaginal bleeding, particularly towards the end of the pregnancy, because the placenta is low down in your uterus. Bleeding from placenta previa can be very heavy, sometimes putting both your and your baby’s life at risk.

It is also possible that your baby may need to be born by caesarean because the placenta is blocking the birth canal, preventing a vaginal birth.

Management of Placenta Previa

Treatment of placenta previa involves bed rest and limitation of activity. However you should understand that there is no medical or surgical treatment to cure placenta previa. But there are several options to manage the bleeding caused by placenta previa.

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.

The best strategy to deal with placenta previa will be to educate yourself about it, report any incidence of bleeding to your doctor and then follow their advice.

References:
[1] Determinants of placenta previa: a case-control study; Fatemeh Shobeiri, Ensiyeh Jenabi , Manoochehr Karami, Simin Karimi; 2017; DOI : 10.15419/bmrat.v4i06.182; http://www.bmrat.org/index.php/BMRAT/article/view/182
[2] Placenta previa: Management; Charles J Lockwood, MD, MHCMKaren Russo-Stieglitz, MD; Mar 2022, https://www.uptodate.com/contents/placenta-previa-management
[3] Why can’t I exercise during pregnancy? Time to revisit medical ‘absolute’ and ‘relative’ contraindications: systematic review of evidence of harm and a call to action; Victoria L Meah, Gregory A Davies, Margie H Davenport; https://bjsm.bmj.com/content/54/23/1395