The placenta is a connection between the mother and her child. With the help of the placenta, the fetus is nourished and receives oxygen returning the products of metabolism. The course of pregnancy and in some cases the existence of the fetus depends on the condition of the placenta. That is why when the pregnant woman is diagnosed with placenta previa the constant medical supervision is organized.
Variations of Placenta Previa
- Previa Along the Front Wall: It is not much of a diagnosis, it is more like a statement of fact and it is necessary that any complications will take place later. But the risk is always possible. Ideally, the placenta should be placed on the rear wall of the uterus where the uterus is less likely to be affected by any changes during pregnancy. The front wall is extensively stretched, thinned and that can lead to a detachment of the placenta and its further displacement to the uterine pharynx.
- Lower Placenta Previa: Normally placenta is placed on the uterine fundus. As we know the uterine fundus is at the top, while the uterine pharynx is placed lower. In cases when the placenta is placed low ( low placentation) –it is attached closer to the pharynx, not reaching it less than 6 centimeters. In that case, two scenarios are possible. Either the placenta places even lower than before and that would be considered full or partial Previa. Or it will arise up to the fundus along with increasing walls of the uterus. The childbirth usually undergoes without any problems in case of low placentation.
- Incomplete (Partial) Placenta Previ: There are two types of such Previa, lateral and edge. In cases of lateral Previa the placenta covers about 2/3 of the inner pharynx ( exit from the uterus body to the cervix uterus). In cases of edge Previa about 1/3 is covered. There are no reasons for panicking if you are diagnosed with partial Previa. Very often placenta returns to a normal position before childbirth. The chances of successful childbirth are high though everything is individual.
- Complete (Central) Previa: Is the most difficult case of abnormal placement of the placenta. Placental tissue completely covers the uterine pharynx and the child will not be able to enter the birth canal. Also, the pathology is dangerous to the mother’s life, as the pharynx area is the most stretchable. The placenta is not that stretchable. Uterus increases and detachment of placental tissue takes place which can not be stretched so quick and effective. The integrity of vessels is violated which leads to heavy bleeding. They may begin in the second trimester and may continue till childbirth. That is only possible in case the Caesarian section is performed.
Causes of Placenta Previa
The main reason appears to be the violation of the integrity of the endometrium (mucous layer of the uterus). The fertilized ovum is not able to get attached to the most suitable place – the uterus fundus. That is where the uterus is less stretchable and is able to provide the high-quality exchange of substances between the mother and the fetus due to the good blood supply. Due to some diseases of the circulatory or other systems of the mother the blood supply of the fundus may be violated.
The ovum, in that case, may search for other places for implantation. Also, it may not get attached if the scarring on the uterus body or other damages of the endometrium is observed. Typically such deformations take place as a result of gynecologic curettage (abortion for example). But the problem may not be only in the reproductive system of the mother. In cases of delayed development of the ovum, it may not reach the uterus fundus. It may happen because the ovum, in that case, maybe attached to the inner uterine pharynx.
Symptoms and Complications
The main symptom and at the same time complication of placenta previa is bleeding (spotting). It is caused by detachment of the placenta. Some part of the placenta rips from the uterus damaging the vessels. It should be noted that in cases of low placentation the bleeding is internal, expressed as a hematoma. In the rest of the cases, the bleeding is vaginal. In cases of partial previa bleeding may be observed in the late stages of pregnancy, in cases of full previa since the second trimester. Besides the growth of the uterus placenta previa may be caused by physical activities, sex, gynecological examinations, and uterine tone. As a result of regular bleeding, hypotension may develop (steadily reduced pressure) and anemia (low hemoglobin level). That is why pregnant women with placenta previa should be under doctors’ control and constantly pass examinations. In cases of bleeding and complete Previa after 24 weeks a woman is placed in the hospital where she receives the adjuvant treatment. In some (rare) cases placenta previa causes the death of the fetus.
Placenta Previa Treatment
There is no medical way of treating the placenta previa. Doctors cannot in any way influence such pathology. The only way out is to observe the pregnant and try to eliminate the associated decreases as any kind of negative factors may worsen the situation. Neutralizing the bleeding and reducing the uterus tone are other possible solutions. Very often in complicated cases of placenta previa, the hospitalization is obligatory.
Birth Giving with Placenta Previa
The main danger, in that case, is that during contractions placenta may be completely detached which may lead to fetal hypoxia and bleeding that may be dangerous to mothers’ life. In such cases, emergency surgery may be necessary. As mentioned above childbirth in the case of low Previa is nothing dangerous. In the case of partial Previa each case is considered individually. Central placenta previa is always a cesarean section on the 38th week of pregnancy. Besides, there is a risk of post-partum complications such as bleeding. If it is impossible to stop the bleeding the uterus removal is performed. But those are the rare cases when the mother’s life is in danger.
How Should Pregnant Women Behave in Case of Placenta Previa?
Future mothers with placenta previa should avoid physical activities and emotional stresses. Sharp movements, as well as overwork, should be abandoned. It may be difficult to do but the life of the child depends on that. A woman needs enough sleep, daily rest, fresh air, and emotional peace. Wouldn’t hurt to reconsider the diet by adding the food rich in iron. It is necessary for those who have constant bleedings. Constipation should be avoided. Placenta previa is a serious enough pathology that just cannot but worry the future mother. But she has to pull herself together and take good care of herself and the future child. Besides most of the pregnancies with placenta previa are taken care of and result in successful childbirth.
Born in Belarus, 1985, a pedagogue and family psychologist, mother. Taking part in procedures of social adaptation of the foster children in new families. Since 2015 is a chief editor of the motherhow.com project, selecting the best and up-to-date material for those, who are planning, expecting, and already having babies.