What are the other Names for this Condition? (Also known as/Synonyms)

• Placenta Praevia

What is Placenta Previa? (Definition/Background Information)

• Placenta Previa is a disorder that occurs during pregnancy, generally affecting expectant women who are over the age of 35 years
• The placenta is a pancake-shaped organ generally situated at the top of the uterus. It helps in supplying oxygen and other nutrients to the baby from the mother, through the umbilical cord
• In Placenta Previa, the placenta, whose original location is in the upper part of the uterus, changes its position and grows in the lower part, thus blocking the opening of the birth canal either partially or completely and creating complications during childbirth
• The different types of Placenta Previa include:
  • Marginal Placenta Previa: The placenta is close to the cervix, but does not cover it completely
  • Partial Placenta Previa: The placenta covers a part of the cervical opening
  • Complete Placenta Previa: The placenta covers all of the cervical opening
• The risk factors associated with Placenta Previa are multiple pregnancies, the presence of abnormally-shaped uterus, previous history of the condition, and previous C-sections
• An ultrasound scan, performed during pregnancy, is the best way to diagnose Placenta Previa. Unexpected painless bleeding from the vagina in the last trimester of pregnancy is a very suggestive indicator of the condition
• A Cesarean section may be performed to deliver the baby on an emergency basis, when the bleeding is severe and persistent
• There are no specific measures to prevent the occurrence of Placenta Previa. Nevertheless with early and appropriate treatment, it has a good prognosis

Who gets Placenta Previa? (Age and Sex Distribution)

Pregnant women, generally above 35 years of age, are more likely to be affected by Placenta Previa.

What are the Risk Factors for Placenta Previa? (Predisposing Factors)

The risk factors that increase the incidence of Placenta Previa may include:

• Women with twin and triplet pregnancies; multiple pregnancies
• Women with abnormally-shaped uterus
• Having a previous history of Placenta Previa
• Women with an injury or scar in their uterus, due to a previous:
  • Surgery
  • C-section
  • Pregnancy
  • Abortion
• Smokers or cocaine users
• Women below the age of 20 years or over 35 years of age
• Living in high altitudes
• For some unknown reasons, people from Asia and Africa seem to have a higher risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Placenta Previa? (Etiology)

The place where the embryo fixes itself in the uterus is the place where the placenta grows. When the embryo fixes itself in the lower portion of the uterus, Placenta Previa occurs. Thus, Placenta Previa is a condition in which the position of the organ (placenta) has changed from its normal position.

Some of the possible causes for Placenta Previa include:

• Marks/scars on the uterus lining
• Increase in the size of the placenta caused by giving births to twins or triplets
• The uterus shape is abnormal

What are the Signs and Symptoms of Placenta Previa?

The signs and symptoms manifested by Placenta Previa include:

• Unexpected bleeding from the vagina that occurs in the last trimester of the pregnancy
• Bleeding is almost always painless
• Some women may have uterine contractions

How is Placenta Previa Diagnosed?

The diagnosis of Placenta Previa may involve:

• A complete evaluation of medical history along with a thorough physical exam
• An abdominal ultrasound scan performed during pregnancy is the best way to diagnose Placenta Previa

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Placenta Previa?

Placenta Previa may lead to various complications such as:

• Heavy vaginal bleeding leading to shock and death
• Placenta accreta: It is a condition in which there is a difficulty experienced in separating the placenta from the uterus during delivery, which may lead to life-threatening complications. This may require an hysterectomy (removal of the uterus) to be performed
• Premature birth of the baby with complications such as:
  • Low birth weight
  • Breathing difficulties
  • Partial development of vital organs such as the lungs

How is Placenta Previa Treated?

The treatment strategy for Placenta Previa depends upon the following factors:

• The severity of the bleeding in the vagina
• The duration of the pregnancy i.e., how far the fetus has developed
• Health condition of the expectant mother
• Health condition of the baby
• Position of the placenta

The treatment rendered differs from one individual to another and it is based upon the type of Placenta Previa; whether it is marginal, partial, or severe.

Treatment for Complete Placenta Previa when bleeding is severe includes:

• Cesarean-section: A C-section is performed on an emergency basis, to deliver the child, when the bleeding is severe and uncontrolled or non-stoppable
• Hospitalization to monitor the health of the mother and child
• Blood transfusion, in case of severe and unstoppable bleeding
• If the mother has an Rh negative blood group then a special medicine, called Rhogam, is injected
• Use of steroids through injections to help develop the baby's lungs

Treatment for Partial or Marginal Placenta Previa when there is little or no bleeding includes:

• The activities (or movements) of the expectant mother are restricted and reduced/minimized
• A complete bed rest is recommended
• No sexual intercourse is permitted during this time
• Use of tampons should be avoided
• Vaginal exams are not allowed
• Use of contraceptives that are inserted into the vagina are restricted
• Delivery of the child, when the lungs are mature, to avoid breathing-related difficulties

How can Placenta Previa be Prevented?

• There are no specific measures to prevent the occurrence of Placenta Previa
• Taking sufficient steps to reduce some of the risk factors mentioned earlier, is the only way to prevent its development

What is the Prognosis of Placenta Previa? (Outcomes/Resolutions)

• Severe bleeding that cannot be controlled will place both the mother and child at risk of death. In such cases, an emergency C-section is required to deliver the child prematurely (or preterm) and save the life of both the mother and the child
• With early and appropriate treatment, Placenta Previa has a good prognosis

Additional and Relevant Useful Information for Placenta Previa:

• Cesarean section (or C-section) is a surgical procedure where an incision is made in the lower abdomen, carried down through the muscle and then through the uterus of the mother, to deliver the baby

The following article link will help you understand a C-section surgical procedure:

http://www.dovemed.com/common-procedures/procedures-surgical/cesarean-section/