Placenta Praevia: A Difficult Road to a Beautiful Destination

 

The placenta is your baby’s main support system. It provides nourishment to your baby through the umbilical cord. It also filters the nutrients, oxygen, and waste your baby receives. For most women, the placenta attaches itself to the side of the womb but for some it attaches lower down and could cover a part or all of the cervix.

It is first seen in early ultrasound scans, during this time it is called a low lying placenta. In most cases, the placenta moves upwards as your baby grows. The placenta for some women, however, remains in the lower part of the uterus even after 20 weeks. This is condition is known as placenta praevia. It is observed in 1 of 200 pregnancies.

 

Why does Placenta Praevia happen?

Your placenta grows wherever the embryo has implanted itself in your uterus. If the embryo attaches itself to the lower part of your uterus, the placenta may grow in the lower part of your uterine wall or even over your cervix.

Initial placenta praevia usually resolves itself, that is if your placenta doesn’t completely cover your cervix. The situation gets complicated if the placenta is covering your cervix at any point in time.

 

There are a few particular risk factors for placenta praevia, these include:

Previous Caesarean section: If you have undergone a caesarean section with a previous birth may lead to issues with where the placenta attaches.

Multiple Pregnancy: Being pregnant with twins, triplets, or more puts you at high risk for the condition.

Advanced age: If you are 35 years or older when you’re pregnant you are at an elevated risk for the condition.

Smoking: It contributes to the risk of suffering from the condition.

 

Are there any types of placenta praevia?

“Praevia” is a word of Latin origin which means ‘appearing in front of’. In placenta praevia, it means in front of the cervix. The types of placenta praevia are based on the position of the placenta with respect to your cervix. They include:

Marginal Praevia:

When the placenta reaches the edge of your cervix but does not cover it.

Partial Praevia:

In this case, the placenta covers a part of your cervix but not all of it.

Complete Praevia:

The placenta covers the entire opening of your cervix in this type. It is the riskiest form of placenta praevia.

 

What symptoms can I experience if I have Placenta Praevia?

You may have placenta praevia and not know about it till your doctor spots it on an ultrasound. But nowadays women mostly notice the symptoms of placenta praevia.

Bleeding during pregnancy is the main symptom of placenta praevia. This may be heavy or light and usually occurs in the second half of your pregnancy. You may also experience contractions along with bleeding. But, not all women with the condition have vaginal bleeding.

Light bleeding and spotting are common during pregnancy and placenta praevia may not always be the underlying cause. To confirm the condition it is important that you visit your doctor at the earliest.

 

How is Placenta Praevia diagnosed?

An ultrasound is considered the gold standard in the diagnosis of placenta praevia. It helps pinpoint the exact location of the placenta. In recent times, a transvaginal ultrasound has proven to be more accurate in comparison to a regular ultrasound for diagnosing the condition.

You may also be asked to take an MRI to visualize your placenta clearly. Placenta praevia is usually diagnosed during your second-trimester ultrasound.

 

What will happen if I have been diagnosed with Placenta Praevia?

If you have been diagnosed with placenta praevia you may need repeat ultrasounds in the later part of your pregnancy. If you have light bleeding you may be asked to take bed rest. You might also be advised to avoid exercise and sex as they could both lead to bleeding.

If you have heavy bleeding, however, you may require bed-rest in the hospital.

Having a vaginal birth is not possible in most cases. If you have heavy bleeding you may require a caesarean section as soon as your doctor considers it safe. An emergency caesarean may be conducted if you have unstoppable bleeding.

An elective C-section is recommended at 36-37 weeks of gestation if you have placenta praevia.

 

What are the possible complications of Placenta Praevia?

Placenta praevia puts you at a high risk of bleeding and need for blood transfusion. This happens not only during pregnancy but also during and after delivery.  Here are a few reasons why:

In normal conditions after your baby is delivered by a caesarean section, your doctor delivers your placenta and you are given certain medicines (commonly Pitocin). These medicines help your uterus contract which stops bleeding in the area your placenta was implanted. If you have placenta praevia, however, your placenta will be attached to the lower part of your uterus. It will not contract as well as the upper part and so the contractions won’t be very effective in stopping the bleeding.

It is also likely that your placenta is implanted too deeply and won’t separate easily at the time of delivery. This condition is known as placenta accreta and has the potential to cause massive bleeding. It can pose a major risk to your life and may require additional procedures to control the bleeding.

You may also have to have your baby before term (premature), this might put your child at risk for complications such as difficulty in breathing and low weight at birth.

 

What are the treatment options for Placenta Praevia?

The main goal of placenta praevia treatment is prolonging your pregnancy for as long as possible. A few ways to ease the symptoms are:

  • Complete bed rest
  • Monitoring your vitals and your baby’s heart rate at regular intervals
  • Not indulging in any physical activity that may trigger bleeding

You may have to undergo a caesarean during any stage if you have excessive bleeding or in case of other serious problems. A vaginal birth may be considered if you have marginal praevia, but it will always be risky. Hence, it is wise to have a caesarean to avoid further complications.

 

Can placenta praevia be managed with natural remedies?

Several claim to provide magic fixes to the condition ranging froalm acupuncture to herbal remedies. But the harsh truth is that these aren’t supported by any scientific evidence. If you opt for natural remedies instead of an elective caesarean you put yourself and your baby at risk of several complications. You may potentially bleed to death or your blood pressure may fall rapidly which may become very difficult to manage if you go into labour.

 

Despite all these complications, advancements in technology and medicine have made it possible to detect and manage the condition as early as possible. There has also been a significant decline in the maternal mortality rates in the recent years. The credit for this goes to the tireless efforts of maternity care hospitals and their dedicated staff. Being diagnosed with placenta praevia is no longer a stressful and nerve-wracking for moms-to-be.


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