Published: Mon, May 22, 2017
World | By Tasha Manning

Placenta Previa in Pregnancy. Is it very serious?

Placenta Previa in Pregnancy. Is it very serious?

Written by Dr.M.D.Mazumdar, MD

Placenta previa is a type of antepartum hemorrhage.

Antepartum hemorrhage is defined as bleeding from the genital tract that occurs after the 28th week of pregnancy until the birth of the baby.

Other Causes of Antepartum Hemorrhage

Placenta previa is a condition where the placenta is implanted completely or partially in the lower part of the uterus.

The incidence of placenta previa is about 1 in every 200 pregnancies. In the USA, the incidence is 0.3-2.0%. Types of Placenta Previa

There are 4 types of placenta previa, classified as placenta previa, classified According to the position of the placenta on the uterine wall.

Low lying placenta previa: Also called the Type 1 placenta praevia. In this type of placenta previa, the placenta is in the lower part of the uterus but does not reach the internal ones of the cervix. Marginal placenta previa: Also called the type 2 placenta previa, here, the edge of the placenta It is more dangerous if the placenta is implanted at the posterior or back wall of the uterus. Partial placenta previa: The placenta covers the internal part of the cervix partially. Complete Placenta previa: The placenta lies over the internal of the cervix, completely covering it.

Risk factors for Placenta Previa

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Bleeding

Bleeding : The most important and sometimes the only symptom is bleeding through the vagina. The bleeding is mostly painless, apparently causeless, and can not be controlled by medicines. Many patients will complain that they found themselves 'in a pool of blood' on getting up from sitting or lying down position.

Bleeding usually occurs after 28 weeks of pregnancy, although it may occur earlier. It starts spontaneously and can spontaneously stop when the patient stays at bed rest. Symptoms of blood loss: If the bleeding has been occurring for some time, the patient may be brought to the hospital with symptoms of blood loss like low blood pressure.

, Or even in a state of shock. On Examination:
  • The uterus is not on palpation.
  • The height of the uterus corresponds to the gestational age calculated from the LMP.
  • Fetal heart rate is usually normal (if bleeding is not much).
  • The presenting part of the fetus is high up and can be easily palpated through the abdomen.
  • There may be abnormal presentations like breech or face presentations. Ultrasonography is the most valuable aid in the diagnosis of placenta previa.
With routine ultrasound being done at around 16 weeks of pregnancy at most hospitals, placenta previa can be detected quite early. About 90% of the placenta identified prior to 16 weeks tended to migrate upwards with the enlargement of the uterus. And by the 28th week of pregnancy, they are present in the upper segment of the uterus.

Treatment 0f Placenta Previa

Treatment depends on the amount of bleeding and the maturity of the fetus. If the bleeding is less and the fetus is not mature (less than 34 weeks): Conservative treatment is done by admitting the patient in the hospital, keeping the patient at Complete bed rest and under careful observation. Steroids to make the fetal lungs mature are given if the patient is less than 34 weeks of pregnancy.

If bleeding is less and the fetus is mature: A cesarian section is done. If bleeding is severe and uncontrollable and the fetus is not mature: If bleeding is severe, the only option is to stop the cesarian section to save the life of the mother. With newborn care it is possible to save a preterm baby in a hospital with the proper infrastructure. Treatment of symptoms of blood loss: IV fluids, blood transfusion etc. May be needed. Maternal complications include hysterectomy, antepartum bleeding, intrapartum and postpartum bleeding, as well as blood transfusion, septicemia.

, And thrombophlebitis. Maternal mortality (death of the patient) is rare in a well equipped hospital. Perinatal mortality (death of the fetus) occurs in around 4% - 8% of patients, mostly due to prematurity.

Fetal Complications of Placenta Previa

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