Placenta previa occurs in about 0.5% of pregnancies. Medical measures are based on the severity of the symptoms.
What is placenta previa?
Placenta previa is a malposition of the placenta in pregnant women. Depending on the form of placenta previa, the birth canal is covered by the placenta to varying degrees. See sportingology for Meaning of Interstitial Nephritis in English.
In the context of the so-called placenta previa marginalis, the placenta makes contact with the internal cervix, but a vaginal delivery is usually possible. If, on the other hand, there is placenta previa totalis, the internal cervix is completely covered by the placenta; as a rule, a birth here has to be carried out using a caesarean section.
One of the main symptoms of placenta previa is vaginal bleeding, which occurs towards the middle of pregnancy. This is usually just maternal blood. Placenta previa occurs primarily in women who give birth to many children and/or women with multiple births.
Causes
Placenta previa occurs due to the implantation of a fertilized egg in the lower part of the uterus. Statistically, the risk of placenta previa increases if a woman’s uterus has been damaged in the past.
Corresponding damage can be the result of inflammation of the uterine lining or previous caesarean sections. Factors such as previous miscarriages, scrapings of the uterus or so-called manual removal of the placenta also have a favorable effect on the development of placenta previa.
In medicine, manual placental ablation is the necessary surgical removal of the placenta, which does not detach itself from the uterus on its own after the birth process has taken place. The exact causes of implantation of a fertilized egg cell in the lower uterine area are still largely unknown.
Symptoms, Ailments & Signs
Placenta previa is a malposition of the placenta in pregnant women. The too low position of the placenta, which can partially or completely cover the cervix, manifests itself in the middle to last trimester of pregnancy by bleeding from the vagina. These can be intermittent, but they can also be continuous, most often being bright red blood that comes from the mother.
If, in rare cases, the villi are also damaged, it can also be the child’s blood that is leaking out. The bleeding is not usually painful, but the pregnant woman can lose a lot of blood if the placenta completely covers the internal cervical os, which in some cases can lead to shock. The loss of blood often leads to circulatory problems and dizziness.
With placenta previa, the abdomen remains soft and not sensitive to pressure. It often affects women who have already had several caesarean births or who have undergone abortions after miscarriages. In the case of placenta previa, bed rest is often necessary or, in the case of heavy bleeding, inpatient admission to the hospital. Most of the time, a caesarean birth is necessary because a natural birth carries the risk of excessive blood loss.
Diagnosis & History
The suspicion of an existing placenta previa arises in various cases due to bleeding occurring during the last three months of pregnancy. Such bleeding is typically painless.
Preventive examinations during pregnancy using ultrasound can also indicate the presence of placenta previa; the corresponding images allow an exact localization of the placenta. If placenta previa is suspected, doctors strongly advise against carrying out a medical examination of the vagina (vagina) by touch; this can increase bleeding.
As placenta previa develops, the lower uterine area stretches. These stretches are facilitated by contractions of the uterus (the womb). Due to the stretching of the uterus, the placenta can now partially detach from the lining of the uterus and tear. The bleeding that is typical of placenta previa then occurs. As a rule, medical measures are now required to ensure the integrity of mother and child.
Complications
Those affected by placenta previa usually suffer from various symptoms that can occur during pregnancy. This can be noticeable in heavy bleeding, which does not have to be associated with pain. There are also no contractions and the patient’s stomach feels very soft. In most cases, placenta previa is not associated with any particular complications or other serious harm.
In most cases, the child also develops normally, so that there are no complications here either. However, in many cases placenta previa can lead to depression or other psychological problems and possibly to anxiety in the patient. For this reason, a doctor must be consulted with this disease in any case.
Placenta previa is treated with medication. There are usually no complications and the symptoms disappear relatively quickly. A caesarean section is only necessary in severe cases of placenta previa. Most of the time, however, there are no particular complaints.
When should you go to the doctor?
Placenta previa must always be treated by a doctor. If the disease is not treated, it usually leads to a stillbirth and thus to further serious complications. Self-healing does not occur in this disease. A doctor should be consulted for placenta previa if irregular bleeding occurs during pregnancy. The severity of this bleeding can vary widely, with the blood usually being bright red.
Those affected also suffer from dizziness or circulatory problems, which can significantly reduce their quality of life. In most cases, the bleeding is not associated with pain. If these symptoms occur during pregnancy, a doctor must be consulted immediately. The placenta previa is treated by a gynecologist. In an emergency, the hospital should be visited, for further treatment an operation is necessary. The life expectancy of the mother is not negatively affected by the placenta previa.
Treatment & Therapy
Professional treatment of placenta previa depends on various factors. The severity of any bleeding, the degree of maturation of the fetus and the general condition of the mother-to-be play a role here, for example.
In various cases where placenta previa is present, inpatient treatment of the affected woman makes medical sense. If placenta previa causes the patient only light bleeding and the child cannot yet be delivered due to its stage of development, doctors often prescribe anti-labor drugs.
In addition, depending on the individual case, active ingredients that promote the lung maturation of the fetus can be used. Doctors also often recommend consistent physical protection. Such protection serves to avoid renewed bleeding.
If the placenta previa is accompanied by heavy bleeding and/or the development of the child already allows delivery, this is often carried out as quickly as possible using a caesarean section.
Outlook & Forecast
The prognosis is as different as the course of placenta previa is individual. Both a low-lying placenta and a placenta previa marginalis can go completely unnoticed, while a placenta previa totalis can sometimes even be accompanied by heavy bleeding and great danger to life.
In the case of placenta previa, possible bleeding usually stops spontaneously, so treatment is not necessary. However, it can also happen that bleeding becomes life-threatening for the expectant mother and the unborn child. It can also happen that bleeding that has already been stopped starts bleeding again after a few days or even weeks. However, with the right treatment and a conscious approach to the situation, it is still possible for patients with placenta previa to give birth to healthy children. For the prognosis, it is irrelevant whether a spontaneous birth or a caesarean section is carried out.
As a general rule, the more placental tissue covering the cervix, the greater the likelihood of bleeding before or during childbirth. However, the risks themselves are generally very low. The maternal mortality rate is less than one percent, and the fetal peripartum mortality rate (mortality rate before or during birth) is around ten percent. If a mother-to-be has already been diagnosed with placenta previa, the risk of this disease recurring is up to eight percent.
Prevention
Since the exact causes of an occurring placenta previa are largely unclear, prevention is hardly possible. However, regular check-ups during pregnancy can help to identify a possible placenta previa at an early stage. Among other things, this enables measures to be taken that can reduce the risk of bleeding occurring in the presence of placenta previa (such as physical rest for the expectant mother).
Aftercare
In most cases, those affected with placenta previa only have very limited follow-up measures available, so that a doctor should be consulted at an early stage. Only with a timely diagnosis can further complications be prevented, so that an ordinary pregnancy also proceeds. A doctor should therefore be consulted as soon as the first signs and symptoms of placenta previa appear.
In most cases, those affected are dependent on taking various medications. It is always important to ensure regular intake with the right dosage in order to relieve the symptoms permanently and correctly. If anything is unclear or you have any questions, always consult a doctor first.
Regular checks are also necessary during treatment in order to monitor the current state of the disease. In an emergency, a caesarean section must be performed. In many cases, the affected parents also depend on the psychological support of friends and relatives. This can prevent depression and other mental upsets. The further course of placenta previa depends very much on the severity of the disease, so that a general prediction is not possible.
You can do that yourself
Placenta previa can hardly be countered by self-help measures. Diagnostic tools for fighting are exclusively regular check-ups, but they fall within the medical field. Essential everyday tips can be summarized under the term “protection”.
Affected women should not expose themselves to psychological pressure. In everyday life and at work, it is important to slow down. Stress regularly leads to the well-known symptoms of placenta previa. Adhering to rest periods has proven to be particularly effective. An afternoon nap and a comfortable lying position on a sofa are sometimes the best means. Sporting challenges are generally to be avoided. Women should take special care of the area around the pelvis. This includes not having sex as well as not doing vaginal douching. Tampons or other objects should never get into the vagina.
The partner and close friends and relatives should pay particular attention to the harmony in everyday life when diagnosing placenta previa. By taking on tasks, you can help to ensure that the mother-to-be is cared for. Last but not least, this also serves the well-being of the unborn child. Complications from psychological causes should not be underestimated.
