What is placenta praevia?
The placenta develops wherever the fertilised egg embeds in your uterus after its journey along the fallopian tube. Sometimes, it attaches itself to the lower part of your uterus. In this case, the placenta will develop in a low-lying position.
If you have an ultrasound scan in early pregnancy and the placenta seems to be near your cervix, don't be too worried. As your baby grows, your expanding uterus naturally pulls the placenta upwards away from your cervix.
If the placenta is still lying low in your uterus after you are 20 weeks pregnant, it is called placenta praevia (RCOG 2005a). Even at this stage, the placenta may still move up in time for your baby to be born. By the end of pregnancy, about one in 200 women has placenta praevia to some degree (Neilson 2003). Most of these are minor cases.
If the placenta covers your cervix at the end of your pregnancy, your baby's exit route through your vagina will be blocked. The placenta may be partly covering your cervix (partial placenta praevia) or completely covering it (major placenta praevia). See our images, below. Either way, your baby will need to be born by caesarean section.
How common is placenta praevia?
If you have an ultrasound scan in early pregnancy and the placenta seems to be near your cervix, don't be too worried. As your baby grows, your expanding uterus naturally pulls the placenta upwards away from your cervix.
If the placenta is still lying low in your uterus after you are 20 weeks pregnant, it is called placenta praevia (RCOG 2005a). Even at this stage, the placenta may still move up in time for your baby to be born. By the end of pregnancy, about one in 200 women has placenta praevia to some degree (Neilson 2003). Most of these are minor cases.
If the placenta covers your cervix at the end of your pregnancy, your baby's exit route through your vagina will be blocked. The placenta may be partly covering your cervix (partial placenta praevia) or completely covering it (major placenta praevia). See our images, below. Either way, your baby will need to be born by caesarean section.
How common is placenta praevia?
Some women are more likely to have placenta praevia than others. You are more likely to have the condition if you:
- have had a baby before;
- have had a caesarean section before;
- are a smoker;
- are over 35.(NCCWCH 2008)
How is a low-lying placenta diagnosed?
A low-lying placenta may be picked up during a second trimester ultrasound scan. If the placenta is just reaching or overlapping your cervix, your doctor will keep monitoring it.
In about half of cases, a third trimester scan will show that the placenta has moved up and out of the way (RCOG 2005b). If not, there's still time for it to do so. In about a quarter of cases, the placenta will have moved up after 34 weeks and in time (NCCWCH 2008) for birth.
Occasionally, placenta praevia is picked up in other ways:
In about half of cases, a third trimester scan will show that the placenta has moved up and out of the way (RCOG 2005b). If not, there's still time for it to do so. In about a quarter of cases, the placenta will have moved up after 34 weeks and in time (NCCWCH 2008) for birth.
Occasionally, placenta praevia is picked up in other ways:
- If your baby is in a breech position or is lying across your bump (transverse position). This could be a sign that she is unable to get into a head-down position, because the placenta is in the way.
- If you have painless vaginal bleeding in the second or third trimester. Call your doctor immediately if this happens. (Vaginal bleeding may also be caused by the placenta coming away from your uterus wall. This is called placental abruption, and you'll need to get medical help straight away [RCOG 2005a].)
What complications are linked with placenta praevia?
Remember that only one in 200 women has placenta praevia, and most of these are minor cases. This means that complications seldom happen. However, when complications do arise, they can be serious.
One rare complication is when the placenta embeds itself too deeply in the wall of the uterus. The placenta will stay attached to the uterus rather than coming away after your baby is born. This is called placenta accreta, and is more likely to happen if you've previously had a caesarean (RCOG 2005a, NCCWCH 2008).
If you have placenta praevia there is a risk that you may experience sudden, painless bleeding. This can happen during your pregnancy or your labour. You'll need emergency medical care if this happens, particularly if you've gone into labour early (Neilson 2003). Without treatment, severe bleeding (haemorrhage) can be life-threatening for both you and your baby. On the rare occasions it happens, this type of bleeding can be treated quickly.
It is very unlikely that you would lose so much blood that it posed a grave risk to your health. But sometimes, doctors have to move quickly to stop the worst from happening. In this situation, they may need to protect your health by performing an operation to remove your uterus (hysterectomy).
One rare complication is when the placenta embeds itself too deeply in the wall of the uterus. The placenta will stay attached to the uterus rather than coming away after your baby is born. This is called placenta accreta, and is more likely to happen if you've previously had a caesarean (RCOG 2005a, NCCWCH 2008).
If you have placenta praevia there is a risk that you may experience sudden, painless bleeding. This can happen during your pregnancy or your labour. You'll need emergency medical care if this happens, particularly if you've gone into labour early (Neilson 2003). Without treatment, severe bleeding (haemorrhage) can be life-threatening for both you and your baby. On the rare occasions it happens, this type of bleeding can be treated quickly.
It is very unlikely that you would lose so much blood that it posed a grave risk to your health. But sometimes, doctors have to move quickly to stop the worst from happening. In this situation, they may need to protect your health by performing an operation to remove your uterus (hysterectomy).
How is placenta praevia managed?
Managing placenta praevia is sometimes just a matter of watch and wait. Your medical team will keep track of where your placenta is lying.
Your care will also vary depending on whether you've had any bleeding or not. If you've had no bleeding you'll probably be able to stay at home. You may be advised to avoid making love for the rest of your pregnancy. You should have someone to help you at all times and make sure you can get to hospital at a moment's notice.
If you have had bleeding or you have placenta accreta you'll be asked to come into hospital when you are 34 weeks pregnant. Usually, you'll be recommended to have a planned caesarean when you're between 37 weeks and 38 weeks pregnant. Because you may be more vulnerable to bleeding during the operation, a blood transfusion will be on standby, just in case.
If you're bleeding heavily before you're due to go to hospital, go straight to hospital so that the bleeding can be monitored. When it stops, you may be asked to stay in until your baby is ready to be born. If the bleeding doesn't stop, or you go into premature labour, your baby will need to be born by emergency caesarean section (RCOG 2005a, 2005b).
Your care will also vary depending on whether you've had any bleeding or not. If you've had no bleeding you'll probably be able to stay at home. You may be advised to avoid making love for the rest of your pregnancy. You should have someone to help you at all times and make sure you can get to hospital at a moment's notice.
If you have had bleeding or you have placenta accreta you'll be asked to come into hospital when you are 34 weeks pregnant. Usually, you'll be recommended to have a planned caesarean when you're between 37 weeks and 38 weeks pregnant. Because you may be more vulnerable to bleeding during the operation, a blood transfusion will be on standby, just in case.
If you're bleeding heavily before you're due to go to hospital, go straight to hospital so that the bleeding can be monitored. When it stops, you may be asked to stay in until your baby is ready to be born. If the bleeding doesn't stop, or you go into premature labour, your baby will need to be born by emergency caesarean section (RCOG 2005a, 2005b).
If I have placenta praevia, what can I do to help myself?
You can't do anything to change the position of the placenta. But you can make sure that you stay healthy and well. Eat plenty of nutritious foods, particularly those that are rich in iron. This will reduce your chances of becoming anaemic (RCOG 2005a). If your iron levels are low your doctor may recommend that you take iron supplements.
Having placenta praevia can be worrying for you, particularly if you are waiting to see if your placenta moves up. But there is plenty that can be done to keep you and your baby safe and well.
Credit to http://www.babycenter.com.my/a830/placenta-praevia
Having placenta praevia can be worrying for you, particularly if you are waiting to see if your placenta moves up. But there is plenty that can be done to keep you and your baby safe and well.
Credit to http://www.babycenter.com.my/a830/placenta-praevia
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