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PLACENTA PREVIA
Placenta previa is a condition that occurs during pregnancy when the placenta (the sac surrounding the fetus) implants in the lower part of the uterus and blocks the cervical opening to the vagina, therefore preventing normal delivery.
Q. What causes placenta previa?
A. It is not certain what causes placenta previa in every case. However, the following may contribute or actually cause placenta previa:
- Scarring in the uterine lining (endometrium)
- A large or abnormally shaped placenta
- Multiple fetus' (twins or more)
- Multiple prior deliveries (6 or more previous deliveries)
- Scar tissue from previous cesarean section
Q. Is there anything I can do to prevent placenta previa?
A. Currently, nothing is known to prevent placenta previa.
Q. What are the signs and symptoms of placenta previa?
A. Some of the visible symptoms are:
- Spotting: especially during the first and second trimester.
- Vaginal Bleeding: loss of large quantities of blood during the third trimester; onset is very sudden and often painless.
- Cramping and labor
Indications that are not outwardly visible but may be detected through tests such as an abdominal ultrasound are the positioning of the baby. The baby may be lying in an oblique or transverse position with the placenta lying very low in the abdomen. Also, fetal distress may result from abnormally high maternal blood loss, which may affect the mother's heart rate and blood pressure.
Q. What can be done for placenta previa?
A. The treatment options depend upon the stage of pregnancy, the position of the baby and placenta, the amount of blood loss, degree of fetal distress, and the presence of labor or not.
The onset of severe symptoms before the 36th week of pregnancy will prompt the physician to extend the pregnancy as long as possible. The doctor may order blood transfusion to replace lost blood and administer medications and bed rest to halt labor and delivery.
After the 36th week, most doctors will determine how long delivery can be safely postponed and then deliver the baby by cesarean section. Infant death rate is higher than that of mothers without placenta previa. The higher rate is largely due to the premature births.
Q. What kind of complications could I experience from placenta previa?
A. It is important to call your health care provider anytime you experience any of the symptoms listed above, but especially if you are experiencing vaginal bleeding. If gone undetected, placenta previa can cause blood clots, infections, and major hemorrhaging that can lead to shock and death. With placenta previa and on placenta accreta, the placenta may not easily separate from the uterus. As a result, patients are at increased risk of postpartum bleeding. In severe cases, hysterectomy may become necessary.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-09
7800 Wolf Trail Cove, Germantown, TN 38138
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