Placenta Previa: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Placenta previa is a pregnancy complication in which the placenta completely or partially encloses the cervix, the entrance to the uterus. During pregnancy, the placenta often attaches to the side or top of the uterus. In placenta previa, the placenta attaches itself low in the uterus.

The placenta may cover all or part of the cervix or entrance to the uterus. Placenta previa can cause severe bleeding in the woman before, during, or after birth. It serves to remove waste and provide nutrition and oxygen to the baby.

The placenta and your child are connected by the umbilical cord. Normally, the placenta is attached to the inner wall of the uterus on either the top or side. When placenta previa occurs, the placenta attaches itself lower in the uterus. 

Consequently, placental tissue covers a portion of the cervix. Bleeding can happen after delivery, during labor, or pregnancy. The problem can go away on its own due to uterine and placental changes brought on by pregnancy. The baby is delivered via cesarean section (C-section) if it doesn't.

Causes Of Placenta Previa

The exact etiology of Placenta previa is unknown.

Symptoms Of Placenta Previa

The main sign of placenta previa beyond 20 weeks of pregnancy is bright red, usually painless vaginal bleeding. Spotting can sometimes happen before a more serious blood loss event.

Bleeding could be the result of uterine contractions during labor. In addition, the bleeding could result from having sex or during a medical evaluation. For some women, bleeding may not begin until delivery. Bleeding often occurs as a consequence of uncertain conditions.

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Risk Factors Of Placenta Previa

Placenta previa patients are more prone to:

• Possess uterine scars from a previous operation or surgery, have given birth to a child, had a previous cesarean section, or experienced a previous placenta previa pregnancy.
• Are 35 years of age or older, are expecting after using assisted reproductive technology (ART) for infertility, and are having numerous children.
• Smoking
• Use of Cocaine

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Diagnosis Of Placenta Previa

Placenta previa is identified by ultrasonography either after a vaginal bleeding episode or at a regular prenatal appointment. Most often, placenta previa is diagnosed during a second-trimester ultrasound screening.

Your abdomen could be initially diagnosed with ultrasound equipment. To get more accurate photos, you might also need a transvaginal ultrasound, which uses wand-like technology put within your vagina. The position of the device will be carefully adjusted by your healthcare provider to avoid bleeding or placenta damage.

Also Read: Placental Abruption: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Treatment Of Placenta Previa

If placenta previa is found during a routine exam, you will likely require more frequent ultrasound scans to monitor any placental abnormalities.

When placenta previa is diagnosed early in pregnancy, many women find that the condition resolves on its own. As the uterus grows, the area between the placenta and the cervix may enlarge. In addition, the placenta's growth direction in the uterus may be higher and its borders may shrink in the vicinity of the cervix.

If placenta previa resolves, preparations for a vaginal birth may become feasible. There will be a scheduled C-section if it doesn't go away.

Management of bleeding

Vaginal bleeding is seen as a medical emergency after 20 weeks. You might be admitted to the labor and delivery unit of the hospital. You and your child will be monitored, and you might need a blood transfusion to replace lost blood.

If you are 36 weeks along, the baby will likely need to be delivered via C-section. If you are suffering from serious blood loss or there is a risk to your health or the health of the unborn child, an emergency C-section may be necessary before 36 weeks of pregnancy.

If this was your first episode of bleeding and it has stopped for at least 48 hours, you may be released from the hospital. If you continue to have increasingly severe bleeding episodes, your medical team may suggest you stay hospitalized.

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Treatment when there is no  bleeding

When there is no bleeding, the goal of treatment is to limit the chance of bleeding and to bring you as close to your due date as is practical. Your carer will probably tell you to avoid the following:

• Taking part in a sexual action that could result in an orgasm
• Physical exertion ranging from moderate to vigorous
• Either light or heavy lifting
• Standing for prolonged periods

If you are released from the hospital after a bleeding episode, you will be expected to adhere to these rules to lower the chance that another bleeding episode may occur.

You should get emergency medical help if you are having contractions or vaginal bleeding. If you have help at home that makes it possible for you to be sent to a local hospital, your doctor can ask.

Planned Cesarean section

Even if you did not suffer any bleeding during your pregnancy due to placenta previa, or if you have not experienced any bleeding following the original episode, your scheduled C-section birth time is likely to be between 36 and 37 weeks.

If your delivery is anticipated to take place before 37 weeks, your doctor will prescribe corticosteroids to help your unborn child's lungs develop.

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Complications Of Placenta Previa

To reduce the likelihood of these harmful outcomes, your healthcare provider will monitor you and your child if you have placenta previa:

• Bleeding: Vascular hemorrhage, often known as severe vaginal bleeding, can occur during pregnancy, childbirth, or in the first few hours after giving birth.
• Preterm delivery: If your baby is bleeding excessively before full term, an emergency C-section may be necessary.
• Spectrum of the placenta accreta: The group of illnesses associated with placenta previa is known as the placenta accreta spectrum. The placenta grows through or into the uterine wall in various situations. The placenta accreta has a considerable probability of bleeding throughout pregnancy or after birth.

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