Abnormal Placenta in Pregnancy - Can A Woman Expect Normal Delivery With Placenta Previa?

Abnormal Placenta in Pregnancy - Can A Woman Expect Normal Delivery With Placenta Previa?

In pregnancy, it can be frightening to have complications. And if there are complications that pose risk for life of both mother and the baby, the nervousness is likely to get intense. One of the conditions that can be dangerous to pregnant women and the baby is Placenta Previa.

Placenta Previa

When pregnancy occurs, the tiny life growing inside the body is totally dependent upon the mother for all the nutritional needs. The placenta acts as a nutritional bridge between the mother and the baby as well as mode of transferring wastes from the fetus. But when the placenta is in an abnormal state, pregnancy and delivery can be very complex.

Normally, the placenta attaches to the upper part of the uterus, quite away from the cervix. But in placenta previa, the placenta attaches to the lower portion of the uterus while covering all or some portion of the cervix. This can hinder normal delivery. Experts have classified placenta previa into three types:

  • Complete placenta previa - Where cervical opening is covered completely
  • Partial placental previa - Where cervical opening is covered partially
  • Marginal placenta previa - Where the placenta reaches close to the cervix but doesn't actually cover cervical opening

How common is placenta previa?

According to research, 1 in 200 pregnancies ends up in placenta previa. It is more common in the early phase of pregnancy i.e first 10-20 weeks. About 30 percent of pregnant women will experience it but most of these early cases resolve on their own when the pregnancy progresses.

And by the time a woman reaches her due delivery date, the chance of placenta previa reduces to mere 1 percent. The reason behind placenta previa being less common in late pregnancy is the stretching of the uterus over the period of nine months. As the baby grows during the course of time, the uterus pulls the placenta up and keeps it away from the cervix.

What causes placenta previa?

The exact reason behind placenta previa is still unknown. But there are some risk factors related to the uterus that can increase the chances of developing placenta previa. They are:

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Signs and Symptoms of Placenta Previa

The most common sign of placenta previa is bleeding after 20 weeks of gestation. While most of the pregnant women with placenta previa will experience painless bleeding, a small number of them will experience bleeding with uterine contractions or no bleeding at all.

A pregnant woman who experiences bleeding in the 2nd or 3rd trimester should report it to the doctor immediately. It might be a case of placenta previa.

What are the complications associated with Placenta Previa?

Preterm delivery is the most common complication of placenta previa. Nearly two-thirds of all the placenta previa cases end up in preterm delivery. This is due to fear of dangerous amount of bleeding. Placenta previa in its full potential can be serious. Here are some complications of preterm delivery:

  • Health problems can occur to the baby. In some cases, the baby needs to be admitted to ICU.
  • Blood transfusion becomes necessary in one-third to half of the total cases.
  • Placental separation and heavy bleeding can cause anemia.
  • Intrauterine growth restriction, a condition in which baby in the womb is relatively small compared to its age.
  • About 9-10 percent cases of placenta previa are related to placenta accreta. In this condition, the placenta attaches firmly to the uterine wall. Placenta accreta prevents separation of placenta from the uterine wall during delivery, causing excess of bleeding that sometimes requires surgery (hysterectomy). More than 50 percent of placenta accreta cases need blood transfusion.
  • It can pose an increased risk of neonatal death. It could be stillbirth or newborn dying within one month of life.

Diagnosis of Placenta Previa

Presence of placenta previa is typically detected via abdominal ultrasound. This can be spotted via routine testing usually performed around 20th week of pregnancy. And if you haven’t undergone through ultrasound check, the condition can only be discovered when you start bleeding.

When the abdominal placenta isn’t enough to detect the relation between the placenta and cervix, vaginal ultrasound might be needed.

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Treatment or Management of Placenta Previa

There are currently no medical and surgical procedures to treat placenta previa. But bleeding can be managed through several ways, depending on the health, the amount of bleeding and how far the pregnancy has reached. It can be divided into two categories:

When bleeding is heavy

This needs emergency medical attention and would be requiring blood transfusion. C-section delivery is the only option in this case which is likely to be after 36 weeks of pregnancy. If the doctor plans to deliver the baby after 37 weeks, she might recommend corticosteroids which can help mature baby’s lungs.

When bleeding is light

In this case, the doctor might recommend you bed rest. You would be advised to avoid sex and exercise.

Can a woman with placenta pervia expect normal delivery?

As mentioned in the beginning, if the placenta does not cover the cervix (marginal placenta previa), the doctor would want to examine and confirm the exact location of the placenta. He would then be able to better calculate the risk of vaginal delivery.

The fact of the matter is that most women with placenta previa are able to carry their babies till the full term without serious complications. But if you are experiencing any signs and symptoms, contact your gynecologist or obstetrician that would better guide you through all this.

Glossary

Cervix - Lower part of the uterus that connects vagina to the uterus