Placenta Previa | mombabykids.com
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| Placenta Previa |
Placenta praevia: Definition, Risks, and Management
A placenta that is inserted too low and partially or completely covers the cervix is called "previa." Because this uterine anomaly is rare, but not insignificant.
Definition: What is placenta previa?
The placenta is the key organ that connects mother and baby during pregnancy, filtering the maternal blood supplied to the fetus. In less than 5% of pregnancies , the placenta is inserted too low. This placental abnormality is called placenta previa. While in 2% of pregnancies, placenta previa occurs in the second trimester, it resolves on its own before delivery in 90% of cases.
Central (covering) placenta previa and marginal (partial) placenta previa
Placenta previa is a placenta inserted in a lower part of the uterus, called the lower segment . This placenta then completely or partially covers the cervix . We speak of central placenta previa when it completely covers it and marginal placenta previa when it partially covers it.
Placenta previa: What causes a low-lying placenta in pregnant women?
Causes of this configuration include the shape of the uterus, the presence of fibroids that can prevent the placenta from implanting higher, and smoking. Age is also a risk factor: women over 35 are more affected than others. The risk also increases in the case of multiple pregnancies.
Placenta previa: Can having had placenta accreta play a role?
Furthermore, as with placenta accreta (deep implantation of the placenta in the uterine muscle) during a previous pregnancy, curettage, cesarean section, or any other uterine surgical procedure that resulted in a scar can lead to a low-lying placenta. However, not all women with this placental condition have a scarred uterus.
Diagnosis of placenta previa: what are the clinical signs? How can it be recognized on an ultrasound?
Most often, placenta previa is detected by ultrasound, from the first trimester of pregnancy , because the patient has unexplained bleeding.
What are the risks of placenta previa?
This anomaly often leads to prescribing a very early work stoppage and strict rest, in order to avoid any contractions . Indeed, having contractions can increase bleeding, with a risk of hemorrhage that can lead, among other things, to premature delivery .
Placenta previa: How to sleep? Can you have sex?
A period of rest is therefore strongly recommended for the expectant mother, as well as a break from sexual intercourse and intense physical activity. To sleep, the pregnant woman can position herself however she likes, without any particular additional risk.
Furthermore, since digital cervical examination can increase bleeding, vaginal examination is also contraindicated.
How to raise a low placenta?
There is no method to bring a low-lying placenta up. However, it is possible for it to rise spontaneously up to the 32nd week of pregnancy (34 weeks) .
Placenta previa: is there a treatment?
In addition to these precautions, close monitoring by ultrasound can be implemented from the third trimester, to see how this placenta is developing.
When there is a first bleeding before 36 weeks of amenorrhea , the expectant mother will have to be hospitalized until the bleeding stops.
If there is a second episode of bleeding, the patient will be readmitted to the hospital and may be kept for observation until delivery.
When early delivery becomes necessary and the gestational age is less than 34 weeks of amenorrhea , some physicians will administer corticosteroids to the patient to accelerate fetal lung maturity.
Placental Position: What are the symptoms and risks of a low-lying placenta? Are there any possible complications?
The main symptom of placenta previa is unexplained, painless, bright red bleeding, most often in the second half of pregnancy.
It can cause many complications for both the fetus and the expectant mother. These include:
- intrauterine growth retardation with fetal distress (lack of oxygen);
- hemorrhage requiring a maternal transfusion;
- a placenta accreta;
- premature delivery.
Placenta previa: How does delivery take place? Is a cesarean section necessary?
As the due date approaches, and since there is no treatment for placenta previa, the medical team will have to decide what to do next. A placenta previa that covers the cervix completely will necessarily require a cesarean section, otherwise the risk of postpartum hemorrhage will be greater.
Low Placenta During Pregnancy: How High Can It Go?
However, the placenta may move slightly during pregnancy up to 34 weeks of amenorrhea. It may, for example, be covering during the first trimester, then rise during the pregnancy .
Also, if the placenta is located 3 or 4 centimeters from the cervix, a vaginal delivery is quite possible . Only the final position of the placenta before delivery will decide the method chosen to deliver the baby.
