Placenta previa is a pregnancy complication. When we say “complication”, it may sound alarming. However, understanding a condition can make it less scary. Placenta previa occurs when the placenta attaches to the lower side of the uterus. It can potentially block your cervix, making vaginal birth difficult. You must understand the placenta as a vital organ for your baby.
This blog delves into the definition, symptoms, causes, and dos and don’ts of placenta previa. We aim to guide you through this condition step by step, so you can make more informed decisions throughout your pregnancy.
What is Placenta Previa?
Let’s examine the placenta as an organ.
The placenta forms in the uterus during pregnancy, attached to the top or side of the uterus. This organ is the source of all the nutrients and oxygen for your baby. It also works as a filter to remove the baby’s waste. The placenta and the baby are attached through the umbilical cord. If there is an issue with the placenta, it can lead to a complication in the pregnancy. The placenta is usually lower in the uterus during the first few months of pregnancy. It should move upwards as the pregnancy progresses.
Placenta Previa refers to a pregnancy complication where the placenta does not move upwards, blocking the cervix. In a healthy pregnancy, the placenta moves to make way, so the baby can move out of the cervix and through the vagina. Vaginal delivery, in the case of placenta previa, becomes highly unsafe. Placenta previa can cause vaginal bleeding during the second half of the pregnancy. The bleeding can occur before, during, or after the delivery. Typically, placenta previa patients have to undergo a C-section. Placenta previa can be diagnosed during a routine ultrasound. An ultrasound can detect placenta previa even when you don’t exhibit any symptoms.
Types of Placenta Previa
There are three distinct types of placenta previa: marginal, partial, and complete.
Marginal Placenta Previa
Marginal placenta previa occurs when the edge of the placenta sits close to the edge of the cervix opening. It does not cover the entire opening, but rests within 2 centimetres of the opening. While it is considered placenta previa, it is not as severe as partial or complete placenta previa. Vaginal delivery may be possible with this type of placenta previa. However, it varies from patient to patient. Your healthcare professional may monitor you closely to check for vaginal bleeding or progression of the condition.
Partial Placenta Previa
In Partial Placenta Previa, the placenta covers a substantial portion of the cervix opening, but not the entire opening. It can cause vaginal bleeding during the second half of the pregnancy and increase the risk of pregnancy complications. Most patients with partial placenta previa cannot give birth vaginally and undergo a cesarean section. A partial placenta previa is monitored closely to evaluate any progression of the condition. In some cases, the placenta may move upwards on the inner wall of the uterus. In doing so, it may reduce the risk of pregnancy complications.
Complete Placenta Previa
Complete Placenta Previa is a serious pregnancy complication. The placenta sits right on top of the cervix opening, blocking the exit path for the baby. Out of all the types of placenta previa, complete placenta previa is the most severe form. Vaginal birth is not possible for people with complete placenta previa; a C-section is often the answer. Complete placenta previa also increases the risk of vaginal bleeding, especially during labour and in the late stages of pregnancy.
Placenta Previa Causes & Risk Factors
The exact cause of placenta previa is unknown, although research can point out certain risk factors or potential causes. It can help healthcare providers get an idea of who may be at risk. Research also suggests that there may be several factors that potentially cause placenta previa. Let’s take a look at some of these potential causes and risk factors.
- Irregular Uterine Shape: An abnormally shaped uterus could increase the risk of placenta previa. The irregular shape can affect placenta implantation during pregnancy.
- Uterine Scaring: Uterine scarring from a previous surgery, like a cesarean section, fibroid removal, etc., can affect placenta implantation. It can increase the risk of the placenta attaching to the lower side of the uterus or covering the cervix.
- Multiple Pregnancies: If you have been pregnant before, or if you are pregnant with twins, triplets, or more, there is an increased risk of developing placenta previa.
- Advanced Maternal Age: If you are 35 years old or above and pregnant, your age can increase the risk of placenta previa.
- Substance Use During Pregnancy: Smoking or using substances during pregnancy can increase the risk of various pregnancy complications, including placenta previa. Smoking or substance use can directly affect the placenta, which can lead to complications during or after pregnancy. It can also greatly impact the baby, which may be visible during pregnancy or after birth.
- Previous Case of Placenta Previa: Having a history of placenta previa may make you more susceptible to developing the condition again in your next pregnancy.
- Assisted Reproductive Technology: Some research indicates that using assisted reproductive technology, such as In Vitro Fertilization (IVF) or other fertility-improving treatments, can potentially increase the risk of placenta previa.
Also Read: https://livlong.com/blogs/health-and-wellness/treatment-for-infertility
Signs and Symptoms of Placenta Previa
The most common signs and symptoms of placenta previa are vaginal bleeding during the late stages of pregnancy or labour and cramping or contractions in the abdomen or back.
The amount of vaginal bleeding may vary from person to person, but the blood would be bright red. For some, the bleeding is as little as spotting, while for others it may be to the extent of a haemorrhage. You may not experience pain along with the bleeding. Any bleeding during pregnancy should be taken seriously, regardless of the risk factors of placenta previa.
You may also experience uterine contractions. Occasional uterine contractions are normal during pregnancy, such as Braxton Hicks, which typically occurs in the late stages of pregnancy. It is easy to confuse placenta previa contractions with Braxton Hicks contractions. Placenta previa contractions may often be accompanied by bleeding.
Another sign of placenta previa is fetal distress. Your baby may show signs of distress. Their heart may be abnormal, or they may have reduced movement.
Difference Between Placenta Previa and Abruptio Placentae
Placenta previa and abruptio placentae are both complications of the placenta. Their differences lie in the causes, symptoms, and management. Let’s take a look at the difference between placenta previa and abruptio placentae.
Placenta previa occurs when the placenta attaches to the lower part of the uterus instead of the upper part or the side walls, which is considered the normal placement for the organ. Symptoms of placenta previa include vaginal bleeding, uterine contractions, abdominal pain, and more. The bleeding caused by placenta previa is typically not accompanied by pain, and the blood is bright red. If you have had previous uterine surgeries, multiple pregnancies, or if you are at an advanced maternal age, there is an increased risk of developing placenta previa. Management for placenta previa includes bed rest, monitoring, and potentially a C-section.
Abruptio Placentae or Placental Abruption refers to a condition where the placenta detaches from the uterine wall before delivery. This condition causes symptoms such as painful vaginal bleeding, which may be dark red. The bleeding may not always be apparent; in some cases, the blood is “concealed” or trapped inside the uterus. Risk factors for placental abruption include maternal high blood pressure, abdominal trauma, substance misuse, and more. Management for abruptio placentae includes immediate delivery, where there may be a possibility of a C-section, especially in the case of severe separation.
Vasa Previa vs Placenta Previa
Vasa Previa and Placenta Previa are both conditions related to complications with the placenta during pregnancy. They are both serious conditions, but have different causes and symptoms. In placenta previa, the placenta attaches lower than normal, blocking the cervix opening.
Vasa previa refers to a condition where the fetal blood vessels run through the amniotic membranes over or near the cervix. These fetal blood vessels are unprotected by the umbilical cord or placental tissue. If these vessels rupture during delivery, it can cause serious complications such as rapid fetal blood loss, fetal distress, exsanguination, or death. One of the most common ways to manage vasa previa is an elective C-section before labour to prevent the rupture of the blood vessels.
Management of Placenta Previa
Placenta previa is diagnosed using tests such as a vaginal ultrasound, a transvaginal ultrasound, or an abdominal ultrasound. These tests can show the extent to which the placenta is covering the cervix opening. Management for placenta previa requires a lot of care and close attention. For patients with placenta previa, the following management methods are used:
- Monitoring: Placenta previa is often first caught in an ultrasound. Once the condition has been diagnosed and your level of symptoms has been determined, the next step begins: monitoring. Placenta previa requires close monitoring as it can cause significant distress to both mother and child. You’ll be asked to do regular ultrasounds to ensure the baby’s health is not impacted and to see if the placenta has moved. In some cases of placenta previa, the placenta can correct its position without external intervention.
- Pelvic Rest: You mustn’t engage in an activity that can increase the risk of bleeding. This means activities like intercourse or vaginal examinations are not recommended. It can increase your risk of vaginal bleeding.
- Bed Rest: Since placenta previa presents symptoms in the latter half of the pregnancy, the mother may be put on bed rest. Bed rest can help reduce the pressure on the cervix, preventing preterm labour.
- Emergency C-section: An emergency C-section may be performed if the bleeding is severe or the baby’s health is compromised.
- Fetal Monitoring: Once diagnosed with placenta previa, your health and the baby’s health will be continuously monitored. The monitoring is especially important during labour or when bleeding occurs.
- Transfusions: If the bleeding is severe, your healthcare provider may conduct blood transfusions.
- Patient Education: You must understand how placenta previa works, what causes the condition, and what its symptoms look like. If you know the symptoms, you can catch it early. If you understand the complications, you can receive adequate treatment. Understanding a condition well also prepares you to advocate for your health and your baby’s health.
- Emotional & Psychological Support: Having emotional and psychological support from your partner and other loved ones can help you through this stressful condition. You can also receive counselling for the same.
Dos and Don’ts in Placenta Previa
There are certain dos and don’ts that you must adhere to when you have been diagnosed with placenta previa. Let’s break down what you can and cannot do when experiencing this condition.
DOs
- Rest as much as possible. Pregnancy, in general, is difficult and overwhelming. Additionally, experiencing placenta previa can worsen stress, both for your body and mind.
- Keep yourself adequately hydrated. Eat a balanced diet and take the prenatal supplements prescribed by your doctor. Maintaining nutrition during this period is vital for the mother’s and the baby’s health.
- Lay or sit in comfortable positions. We aim to remove any added pressure on the abdomen. Some studies indicate that lying on your left side can improve circulation and relieve any discomfort.
- Prioritize your mental health. Learn to manage stress and anxiety. Engage in soothing activities; something that brings you joy, but won’t be strenuous for your body.
- Adhere to the treatment and management plan. Whatever your healthcare provider has prescribed for you, from activities to medication, follow it strictly. Your health and the baby’s health depend on these management methods.
- Understand the condition well. Learn about the symptoms, causes, treatment plans, and potential complications. Being informed can also make the experience less overwhelming and frightening.
- Go for all the prenatal appointments. When you have placenta previa, close monitoring of the placenta, your health, and your baby’s health is crucial. Any changes to these elements can be caught and treated early if you attend the prenatal appointments diligently.
- C-sections are a common method of management for placenta previa. Prepare for the possibility that you may require a C-section, depending on the type of placenta previa you have.
DON’Ts
- If you are feeling certain symptoms, do not ignore them. Your health and your baby’s health are in question here. If you see symptoms like vaginal bleeding, consult a doctor immediately.
- Avoid strenuous activities. Your body is already under a lot of stress with pregnancy and placenta previa. Avoid lifting heavy things, running, or any other activity that may put pressure on your abdomen.
- Do not have any sexual activity, especially ones leading to an orgasm. Similarly, do not insert a tampon or douche (vaginal douching refers to using water to clean the vagina). Avoid inserting anything in the vagina as it can increase the risk of infection.
- Avoid smoking as it can increase the risk of various pregnancy complications, including placenta previa.
Conclusion
Placenta previa can add to the already existing challenges of pregnancy. It’s important to know that developing placenta previa does not mean you cannot have a healthy birth. With the right medical support, you can treat and manage this condition well, and welcome a healthy baby. Regular monitoring and strictly adhering to the treatment plan can significantly improve your overall well-being. Learn about the condition and have an open & honest conversation with your healthcare provider; no concern is too big or too small. Medical advancements today ensure that this condition does not overshadow your joy of being a parent.
