Getting to Know Placenta Previa, Symptoms and Appropriate Treatment

If not handled properly, this condition can be dangerous for both mother and fetus. Read the full explanation here!

One of the pregnancy disorders that many pregnant women fear is placenta previa.

As we know, the placenta is the only way for the baby to get oxygen and nutrients. So, ensuring the condition of the placenta or the baby’s afterbirth is in good condition is very important.

That is why mothers need to know about this condition as knowledge and prevention.

Table of Contents

What is Placenta Previa?

Getting to Know Placenta Previa, Symptoms and Appropriate Treatment

Placenta previa is a relatively rare pregnancy complication in which the placenta attaches low in the uterus and covers part or all of the cervix or birth canal.

Normally, the placenta is attached to the upper or side of the uterus, while in this case, the baby’s placenta is attached to the lower side of the uterus and covers the birth canal.

This can cause heavy bleeding during pregnancy and labor. Mothers with placenta previa are also at higher risk of having a premature baby, before 37 weeks of pregnancy.

Doctors will usually prohibit pregnant women with this case from doing physical activities that require excessive energy, such as lifting or moving heavy loads.

During labor with this condition, your cervix/birth canal opens during labor. This can cause the blood vessels connecting the placenta to the uterus to tear.

The risk is that it can cause bleeding that is dangerous for you and your baby. Almost all women who have this condition must have a cesarean section to prevent this from happening.

Types of Placenta Previa

Placenta previa can be divided into several types, namely:

Marginal placenta previa : When the placenta is within 2 cm of the cervix but does not physically cover it.
Partial placenta previa: When the placenta covers part of the cervical opening.
Total or complete placenta previa : When the placenta covers the entire opening of the cervix.

Symptoms to Watch Out For

Be aware of symptoms that are dangerous for the fetus.

The appearance of bright red vaginal bleeding without pain in the second trimester is one of the common characteristics of placenta previa. Symptoms of bleeding vary widely, from mild to severe.

Bleeding can stop on its own even without any treatment. However, it will reoccur a few days/weeks later. Some cases are also accompanied by contractions .

Here are some symptoms you should be aware of:

Bleeding occurs after having sex
Severe pain in the abdomen or extreme cramping
Bleeding in pregnancy in the second trimester
Spots or blood appears then stops and then appears again a few days or weeks later.
The baby is in breech position.

Your baby is more likely to be in the breech position when you have placenta previa. That’s because in a typical pregnancy, the most comfortable third-trimester position for your baby is head-down in the uterus, where there’s the most room.

However, with this condition, the placenta takes up the space where your baby’s head would normally gravitate. That can cause him to remain in (or move into) the breech position.

Symptoms of a placenta covering the cervix are not too dangerous if they are noticed early in pregnancy.

In cases like this, mothers are advised to immediately see a doctor. Before much more serious complications occur.

Reason

Getting to Know Placenta Previa, Symptoms and Appropriate Treatment

The placenta grows where the embryo attaches to the uterus. If the embryo attaches at the bottom, the placenta can grow right on top of the cervix, which is the birth canal for the fetus during labor.

This is what then becomes the cause of this condition.

Some other causes are:

There is an abnormality in the placenta
Mother has abnormalities in the lining of the uterus, such as scar tissue or fibroids.
Have a history of endometriosis.

Most of these cases can be detected by ultrasound. If detected before 20 weeks of pregnancy, there is a possibility that the placenta will shift on its own as the uterus develops.

On the other hand, if it is only discovered in the middle of the second trimester, the doctor will decide on the best treatment according to the size of the bleeding.

Placenta previa can also occur due to the following reasons:

Have experienced a similar case in a previous pregnancy
Scars on the uterus, for example having undergone surgery on the abdomen or uterus such as dilation and curettage (although nowadays it is very rare for curettage and dilation to be the cause of placenta previa)
Have given birth to or are pregnant with twins (more than one).
Mother over 35 years old
Mother is a smoker and user of illegal drugs such as cocaine
Just gave birth
Having an abnormally shaped uterus
Breech baby position
The placenta is quite large
Mother has a history of miscarriage in previous pregnancies.

Risk Factors for Placenta Previa

plasenta previa

A diagnosis of placenta previa during the third trimester means that your doctor may not be able to follow your birth plan.

The incident of bleeding caused by previa, if you experience it, can be frightening.

Although it is not harmful to you or your baby, it can cause serious bleeding and premature birth.

The doctor will monitor closely and take precautions to prevent complications. Possible complications of placenta previa include:

1. Age

Placenta previa is more likely to occur in women over the age of 30 than in those under the age of 20.

2. Second or Subsequent Pregnancy

This condition is more common in women who have had at least one other pregnancy.

3. Pregnant with twins

Being pregnant with two or more babies increases the chances of experiencing it.

4. Previous Caesarean Section or Uterine Surgery

Scarring of the uterus from previous surgeries, including cesarean sections, uterine fibroid removal and D and C procedures, increases the risk of placenta previa.

5. Smoking or Drug Use

Using cigarettes or cocaine during pregnancy increases your chances of experiencing a number of complications, including placenta previa.

6. Certain Races

Several studies have shown that Asian and black women have a greater risk of placenta previa than other racial groups.

7. In Vitro Fertilization (IVF)

Assisted reproductive technologies including IVF have been associated with an increased risk of placental problems, including placenta previa.

When Can It Be Detected?

This condition can be detected during an ultrasound examination. The doctor will diagnose placenta previa during an ultrasound at one of the routine prenatal visits.

This test uses sound waves to show whether the placenta is covering the opening from the uterus to the cervix or not.

The doctor will start with a tool called a transducer placed on the abdomen, but if they need a better view, they will use a transducer that goes into the vagina.

Maintenance

According to WebMD, there is no cure for placenta previa. The goal of treatment is to limit bleeding so you can get as close to your due date as possible.

The doctor can give you medication to prevent premature labor . He or she may also give you corticosteroid injections to help your baby’s lungs develop more quickly.

Once the doctor assesses that the baby can be delivered safely (around 36 weeks of pregnancy), they will schedule a cesarean section.

If the bleeding doesn’t stop, you may need an emergency cesarean section, even if the baby is not full-term.

Treatment depends on:

The amount of bleeding . If it is light, your doctor may recommend avoiding activities including sex and exercise. If the bleeding is heavy, you may need to go to the emergency room, be hospitalized, and receive a blood transfusion.
How close are you to your Estimated Due Date (EDD).
Your health and your baby’s health.
Position of the placenta and baby.

Can You Have a Normal Birth?

It is sometimes possible to have a vaginal delivery with placenta previa. However, most pregnant women give birth by cesarean section to avoid potentially life-threatening bleeding.

If the placenta completely or partially covers the cervix in the third trimester, you will have a cesarean delivery, and about 75% will have a scheduled cesarean before labor begins.

If this condition resolves and the placenta does not cover the cervix, you may be able to have a vaginal birth.

If you have not reached 37 weeks of pregnancy and premature delivery is necessary, you will receive steroid injections to mature the baby’s lungs quickly before a cesarean section is performed.

Then, if heavy bleeding occurs after 36 weeks, the doctor may recommend an immediate cesarean section.

Other Complications

If you have placenta previa, your doctor will monitor you and your baby to reduce the risk of these serious complications:

1. Bleeding

Severe and possibly life-threatening vaginal bleeding can occur during pregnancy, labor, or in the first few hours after delivery.

2. Premature Birth

Severe bleeding may result in an emergency cesarean section before your baby is full term.

3. Placenta Accreta Spectrum

Placenta previa is associated with a group of conditions called placenta accreta spectrum . With these conditions, the placenta grows into or through the uterine wall.

Placenta accreta carries a high risk of bleeding during pregnancy or during and after delivery.

4. Vasoprevia

This extremely rare pregnancy complication, which occurs in about 1 in 2,500 pregnancies, occurs when fetal blood vessels from the placenta pass through the vaginal opening.

It’s more common (though still rare) to have placenta previa. Because vasa previa can cause fatal fetal bleeding when the cervix begins to dilate or the water breaks, your doctor will plan an early cesarean delivery.

5. Bleeding and Hysterectomy

If you have this condition, bleeding can sometimes become uncontrollable during labor or in the hours after delivery.

In rare cases, severe bleeding may require blood transfusion and/or hysterectomy (i.e. removal of the uterus).

6. Increased Risk in Subsequent Pregnancy

Having placenta previa during pregnancy increases the risk of having a similar condition and premature birth in a subsequent pregnancy.

Fetal Development with Placenta Previa

During pregnancy, the placenta provides the growing baby with oxygen and nutrients from the mother’s bloodstream.

Placenta previa means the placenta has implanted in the lower part of the uterus, covering the cervix.

When a pregnant woman experiences placenta previa (the placenta has implanted in the lower part of the uterus, above or near the cervix), the baby cannot be born normally.

‘Partial placenta previa’ means the cervix is partially blocked, while ‘complete placenta previa’ means the entire cervix is blocked.

As a result, babies with this condition may experience:

Premature birth : If the bleeding is severe and you need an emergency cesarean section before your baby is full term (40 weeks), your baby may be born too early.
Low birth weight : Difficulty keeping warm and poor weight gain are potential side effects of low birth weight.
Breathing problems : Underdeveloped lungs can make breathing more difficult.

Once the baby is big enough to be born, a cesarean section is usually performed. The baby may need to be monitored in intensive care to make sure everything is okay.

Meanwhile, Mother will undergo a series of tests, including tests to check her blood cell count and blood clotting ability.

Sleeping Positions for Pregnant Women with Placenta Previa

One more thing that mothers need to pay attention to regarding this condition is knowing the sleeping position of pregnant women with this condition.

With the right sleeping position, it is hoped that mothers can get enough bed rest time.

In fact, the sleeping position that you can apply is not much different from the recommended sleeping position for pregnant women in general, namely sleeping on your left side with your knees slightly bent.

According to Dr. Michael Breus’ explanation on The Sleep Doctor page , sleeping on your left side during pregnancy can avoid pressure on the liver and increase blood flow for the mother and fetus.

Therefore, you can try this position so that you can rest comfortably and safely.

When to See a Doctor?

plasenta previa

If the mother experiences bleeding during pregnancy above 12 weeks, immediately contact a doctor to get further treatment according to the symptoms and gestational age.

Bring a family member to the consultation as a preventive measure if the mother experiences further bleeding.

Tell the family member about your condition so that he/she can also answer the doctor’s questions if your condition does not allow it.

Tell your doctor how much bleeding is occurring. Is it just spotting or is the bleeding quite heavy? Also make sure whether the bleeding is accompanied by pain and contractions.

Prevention

In fact, there is no sure way to prevent placenta previa. However, there are several ways to reduce the risk, including:

1. Routine check-ups during pregnancy

Having regular pregnancy check-ups with your doctor or midwife can help identify potential problems, including placenta previa.

Through an ultrasound examination, the doctor can detect the presence or absence of placenta previa and monitor the development of the placenta during pregnancy.

2. Avoid risk factors

Several risk factors can increase the likelihood of placenta previa.

Among others are: maternal age over 35 years, history of surgery on the uterus, smoking, taking illegal drugs, history of miscarriage, and having previously undergone a cesarean birth.

Avoiding these risk factors can help reduce the chances of developing this condition.

3. Maintain a healthy diet and lifestyle

During pregnancy, it is important for mothers to maintain a balanced diet and avoid consuming alcohol and illegal drugs.

Adopting a healthy lifestyle can help maintain placental health and prevent problems that may arise during pregnancy.

4. Maintain a healthy weight

Maintaining a healthy weight during pregnancy can help prevent a variety of health problems, including complications related to placenta previa.

5. Avoid excessive physical activity

Pregnant women should avoid excessive and high-risk physical activity during pregnancy, especially in the third trimester, to reduce pressure on the uterus and placenta.

6. Stay calm and positive

Maintaining a positive mindset and avoiding excessive stress can help maintain the health of the mother and fetus during pregnancy.

Always consult a doctor or midwife if you experience bleeding or other suspicious symptoms.