Overview
Placenta previa is a pregnancy-related condition where the placenta covers the cervix, leading to bleeding during pregnancy or delivery. The placenta is an organ that provides oxygen and nutrition to the baby and removes waste. Typically, it attaches to the top or side of the inner wall of the uterus, but in placenta previa, it attaches lower, partially or completely covering the cervix. This can result in bright red vaginal bleeding during the second or third trimester. Placenta previa may resolve on its own, but if it doesn't, the baby is delivered via cesarean section (C-section). The exact cause of placenta previa is unknown, but certain risk factors include having had a previous C-section, having had a baby, having scars on the uterus, being over 35 years old, carrying multiple fetuses, and using assisted reproductive technology. Severe bleeding can lead to complications such as preterm birth.
Understanding the disease
Symptoms
The main symptom of placenta previa is bright red vaginal bleeding, usually without pain, after 20 weeks of pregnancy. This bleeding may occur with prelabor contractions of the uterus that cause pain. In some cases, bleeding may be triggered by sex or during a medical exam. Bleeding may not occur until labor, and there may not be a clear event that leads to bleeding. If you experience vaginal bleeding during your second or third trimester, it is essential to call your healthcare provider right away.
Risk Factors
Placenta previa, a condition where the placenta covers the opening of the uterus, is associated with several risk factors. These include:
- Having had a previous baby
- Having had a previous C-section delivery
- Having scars on the uterus from a previous surgery or procedure
- Having had placenta previa with a previous pregnancy
- Being pregnant after having an assisted reproductive technology (ART) procedure for treating infertility
- Being pregnant with more than one fetus
- Being age 35 or older
- Smoking
- Using cocaine The exact cause of placenta previa is unknown, but these risk factors may contribute to its development.
Development
The exact cause of placenta previa is unknown. However, certain factors may increase the risk of developing placenta previa. These risk factors include:
- Previous uterine surgery or procedures, such as a C-section or D&C
- Placenta accreta spectrum, a group of conditions where the placenta grows too deeply into the uterine wall
- Multiple gestation (carrying more than one fetus)
- Advanced maternal age (35 or older)
- Previous history of placenta previa
- Previous preterm birth
- Use of assisted reproductive technology (ART) for infertility treatment
- Smoking
- Use of cocaine It's important to note that having one or more of these risk factors does not necessarily mean that a woman will develop placenta previa. However, it may increase the likelihood.
Assessment and Diagnosis
Triage
If you experience vaginal bleeding during your second or third trimester, you should see a doctor right away. This is especially important if the bleeding is severe or if you have prelabor contractions that cause pain. It's essential to seek emergency medical care if the bleeding is heavy or accompanied by severe pain. A healthcare provider can diagnose and manage placenta previa, as well as monitor you and your baby to reduce the risk of complications.
Diagnosis
To diagnose placenta previa, healthcare providers typically use ultrasound imaging during a routine prenatal appointment or after an episode of vaginal bleeding. The ultrasound exam can be done on the abdomen or with a wandlike device placed inside the vagina for more detailed images. Placenta previa can be diagnosed as early as the second trimester, but the condition is most commonly detected during a routine ultrasound exam. If you have any concerns or experience vaginal bleeding, it is essential to consult your healthcare provider for proper evaluation and diagnosis.
Management and Treatment
Complications
The potential complications of placenta previa include bleeding and preterm birth. Severe, possibly life-threatening vaginal bleeding (hemorrhage) can occur during the pregnancy, labor, delivery, or in the first few hours after delivery. If the bleeding is severe, it may prompt an emergency C-section before the baby is full term to reduce the risk of further complications. Placenta previa is also associated with a group of conditions called placenta accreta spectrum, which increases the risk of bleeding during pregnancy or delivery.
Home Remedies
It is important to consult with a healthcare professional for proper diagnosis and treatment of placenta previa, as home remedies may not be effective or safe.
Treatment
Treatment for placenta previa depends on the severity of the condition and whether bleeding occurs. Here are some general treatment approaches:
- Monitoring: If placenta previa is diagnosed early in the pregnancy and there is no bleeding, frequent ultrasound exams will be done to monitor any changes. In many cases, the condition resolves on its own as the uterus grows, and the distance between the cervix and the placenta increases.
- Bed rest: If bleeding occurs, you may be advised to rest in bed to prevent further bleeding. This may involve avoiding activities like moderate or heavy lifting, standing for long periods, and strenuous exercise.
- Blood transfusion: If there is significant bleeding, you may need a blood transfusion to replace lost blood.
- C-section delivery: If bleeding is severe or persistent, or if the baby reaches 36 weeks of gestational age, a planned C-section delivery is necessary to avoid further bleeding and protect the health of the mother and baby. Remember that each case is unique, and the specific treatment plan will depend on individual circumstances. It's essential to follow your healthcare provider's advice and seek immediate medical attention if you experience any bleeding or other concerning symptoms.