Do you also have a low-lying placenta? (Placenta Previa) - Let's be aware of this!

If you're expecting a baby, it's normal to feel scared about even the smallest things. Especially during pregnancy, if you have a little vaginal bleeding, it can be scary, right? At such times, one of the names you might hear is 'Placenta Previa'. Don't worry, today we'll talk about this in a simple way that you can understand.

Do you know what 'Placenta Previa' is?

Okay, first let's see what this 'Placenta Previa' is simply. You know, when the baby is in the womb, the baby gets all the food, drink, and oxygen it needs through the 'placenta'. This placenta is like a bag, which is formed inside the uterus. This placenta is connected to the baby by the umbilical cord. Normally, as the pregnancy progresses, especially in the last three months (i.e. from 28 to 40 weeks), this placenta should be right on top of the uterus. That's when the baby can easily come out through the vagina. But in the case of 'placenta previa', this placenta does not go up like that, but rather completely or partially covers the part of the uterus called the cervix , which is at the bottom of the uterus. Simply put, the way for the baby to come out is blocked by this placenta.

What are the types of Placenta Previa?

There are different ways to deal with this situation. Let's see what they are:

• Marginal placenta previa: This is when the placenta is just at the edge of the cervix. This means it touches the cervix, but does not completely cover it. This type of placenta previa is more likely to go away on its own when the baby is due, meaning the placenta has more room to move up.
• Partial placenta previa: Here, the placenta partially covers the cervix.
• Complete or total placenta previa: This is when the placenta completely covers the cervix , completely blocking the passage to the vagina. This type is less likely to heal on its own .

Regardless of the type of placenta previa, vaginal bleeding can occur during pregnancy and during delivery. Because of the risk of this bleeding, doctors often recommend a cesarean section (C-section).

How common is this condition?

Placenta previa occurs in about one in 200 pregnancies. Doctors usually detect it during an ultrasound scan during the second trimester of pregnancy.

What is the difference between 'Placenta Previa' and 'Placental Abruption'?

Although both of these conditions can cause bleeding during pregnancy, there is a difference between the two. In placenta previa, the placenta is covering the cervix. But the placenta is still attached to the uterus. In placental abruption, the placenta separates from the uterus . While both conditions can cause vaginal bleeding, the causes are different.

Is 'Placenta Previa' the same as 'Anterior Placenta'?

No, these are not the same. Your placenta can develop anywhere in your uterus. An anterior placenta is one that is on the front wall of your uterus, towards your belly. Think of it like having a pillow between your baby and your belly. It doesn't cause the same problems as placenta previa.

What are the symptoms of placenta previa?

The main symptoms that are often seen are:

• Dark red vaginal bleeding . This usually starts in the second half of pregnancy . Sometimes the bleeding stops for a while and then starts again after a few days.
• You may feel mild pain or contractions in the stomach, lower abdomen, or back.

The amount of blood loss can vary from person to person. Most of the time, there is no pain when this blood loss occurs.

Why does Placenta Previa occur?

It's hard to say for sure what causes placenta previa. But there are some risk factors that can contribute to the condition. Things like your pre-existing medical conditions and certain lifestyle habits can contribute to it.

What are the risk factors for placenta previa?

There are several factors that contribute to this situation:

• If you smoke or take drugs like cocaine.
• If you are 35 years old or older.
• If you have been pregnant several times before.
• If you are expecting twins , triplets or more .
• If you have had previous surgery on your uterus , for example, a previous cesarean section ( C-section ) or a D&C (dilation and curettage) .
• If you have had uterine fibroids before.

What are the complications that can occur due to Placenta Previa?

If you have placenta previa, there are certain risks for both you and your baby. Let's take a look at what they are: Complications you may experience:

• Bleeding: You may bleed heavily during pregnancy, during childbirth, or after giving birth.
• Early birth: If you are bleeding heavily, your doctor may need to perform an emergency C-section before your baby is fully 40 weeks pregnant.
• Blood loss: Excessive blood loss can lead to anemia , low blood pressure, pale skin, and difficulty breathing .
• Placenta accreta: This is when the placenta attaches too deeply to the uterine wall. This can cause excessive bleeding after delivery.
• Placental abruption: The placenta can separate from the uterus before the baby is born. This reduces the baby's oxygen and nutrients.

Complications that the baby may experience:

• Premature birth: If you have to have an emergency cesarean section due to excessive bleeding, the baby may be born prematurely, meaning before the due date.
• Low birth weight: If the baby is born with a low birth weight, it may be difficult for the baby to keep warm and gain weight less.
• Respiratory issues: If the lungs are not developed properly, the baby may have difficulty breathing.

Important: Don't be afraid to talk about these complications. Doctors are very attentive to this. They will give you the treatment and advice you need.

Is it possible to have no bleeding when you have placenta previa?

Yes, it can happen. Some people may not have any vaginal bleeding even if they have placenta previa. However, they may feel a slight pain or cramping in their lower abdomen or back. Therefore, if you experience any bleeding or pain in your lower abdomen during pregnancy, you should definitely tell your doctor.

Why does placenta previa cause bleeding?

There are two main reasons for this. Both have to do with how your body is preparing for childbirth. 1. You know, the cervix.It is like the entrance from the uterus to the vagina. In the last part of pregnancy, as the baby is about to be born, the cervix effaces and begins to open. So, when the placenta is on top of the cervix, when the cervix becomes so thin, bleeding can begin. 2. During labor, the cervix opens (dilates) to allow the baby to come out of the uterus and down the vagina. When the cervix opens, the blood vessels that connect the placenta to the uterus can tear and bleed.

Can Placenta Previa Cause Miscarriage?

A miscarriage is the loss of a pregnancy before 20 weeks. Doctors usually detect placenta previa during a scan after 20 weeks, which is when the pregnancy ends. Therefore, it is very rare for placenta previa to cause a miscarriage.

How is Placenta Previa diagnosed?

Doctors often detect this condition during a routine ultrasound scan around 20 weeks of pregnancy. Sometimes, it can also be detected during tests done when symptoms such as vaginal bleeding occur. Your doctor will then continue to perform scans to monitor the location of the placenta.

What tests are used to detect this?

The doctor mainly uses ultrasound scans to check for placenta previa.

• Transvaginal ultrasound: In this test, the doctor inserts a small device (transducer) into the vagina to check the position of the baby, the location of the placenta, and the cervix. This can show the position of the placenta very clearly.
• Abdominal ultrasound: In this test, the doctor applies a gel to your abdomen and then moves a handheld device (transducer) over it. This can also help to see the baby, placenta, and cervix.

The images from both of these scans can be viewed on a monitor. Your doctor will use these scans to tell you how much the placenta is covering your cervix and what needs to be done.

How is Placenta Previa treated?

The main goal here is to prolong the pregnancy as close to the due date as possible. If bleeding continues, a cesarean section (C-section) is often the safest option. Treatment for placenta previa depends on:

• How badly you're bleeding .
• The baby's gestational age , which is how old the baby is.
• The placenta and the baby's position.
• Your and your baby's health.

If your doctor detects this early in the second trimester of pregnancy, the condition may resolve on its own .This means that as the uterus grows, the placenta can move up. However, if it is discovered later in the pregnancy, the chances of it moving up are less. If the placenta is close to the cervix, or only partially covered, and you are not bleeding, your doctor may say things like:

• Reduce strenuous activities like running, lifting weights, and exercising.
• Stay home and get bed rest.
• Do not do things like having sex, using tampons, or douching.
• See your doctor regularly and get scans.

If the placenta previa condition is moderate or severe, or if there is frequent bleeding, other treatments may be considered, such as:

• Bed rest in the hospital.
• Medicine to prevent early labor.
• Steroid shots to help the baby's lungs develop faster.
• Blood transfusions if you are bleeding excessively.
• If the bleeding is too heavy to stop , an emergency C-section may be performed.

Does Placenta Previa go away on its own?

Yes, if it is found in the second trimester of pregnancy, it can go away on its own, meaning the placenta can move up. There is a chance that the placenta will push up as the uterus grows in the third trimester. However, if the pregnancy is advanced and the cervix is ​​closed, it is less likely to go away on its own . Your doctor will continue to scan you to make sure that this condition has resolved before the baby is born.

Can I reduce the risk of placenta previa?

There's really nothing you can do to prevent placenta previa. And there's no surgery or other medical treatment to fix it. However, there are risk factors you can control, such as not smoking and not using drugs like cocaine . Once your doctor has diagnosed you with the condition, there are ways to reduce vaginal bleeding.

What should I expect if I have placenta previa?

The treatment you receive will be specific to your condition, but most people can expect the following:

• Frequent monitoring during the second and third trimesters of pregnancy. The doctor does this to check the location of the placenta and to see if there is a change in symptoms.
• Limiting or modifying physical activities, such as exercising and having sex.
• Blood tests to check blood counts after the baby is born.

Will my baby be born prematurely if I have placenta previa?

That may be the case. Your doctor will decide whether to deliver your baby early based on the amount of bleeding, the location of the placenta, and the gestational age of your baby. At around 36 weeks of pregnancy, it may be best for both you and your baby's health to deliver your baby early. Sometimes mothers wait until 40 weeks, which is full term.

Can I have a vaginal delivery even with placenta previa?

If you have marginal placenta previa (meaning the placenta is close to the cervix but not completely closed), your doctor may be able to deliver your baby normally. However, this can be dangerous because of the risk of bleeding. Your doctor will talk to you about the safest way to deliver your baby.

If I am diagnosed with placenta previa, will I definitely have to have a cesarean section (C-section)?

Yes, in most cases, a cesarean section (C-section) is the safest way to give birth if you have placenta previa. If the placenta is covering even a small part of the cervix, you may bleed heavily if you try to deliver the baby normally. Your doctor will usually schedule your cesarean section a day in advance. However, if you are bleeding heavily at any time, you may need to have an emergency cesarean section.

Can Placenta Previa Cause Birth Defects in the Baby?

Placenta previa is very rare, but if your doctor feels it is safest to deliver your baby early, your baby may be born prematurely. Premature birth can lead to complications such as low birth weight and breathing difficulties.

Will I get placenta previa again?

If you have had placenta previa in a previous pregnancy, there is a small risk of it happening again , about 2% . If you become pregnant again, tell your doctor about it. He or she will be aware of your previous medical history.

Does Placenta Previa Affect My Fertility?

Placenta previa does not affect your ability to get pregnant again. However, there is a small risk of developing placenta previa if you do get pregnant again.

What questions should I ask my doctor?

Your doctor should be able to answer your questions and prepare you for the treatment of placenta previa. Here are some questions you can ask:

• Is the baby's life in danger? Is my life in danger too?
• What treatment options do I have?
• How do I know if my placenta previa has gone away?
• Do I need to limit some activities?
• Can I have the baby right now?
• What complications can occur?
• Will I need to have more scans or other tests?
• What are the signs that I need to go to the hospital?

What kind of questions will my doctor ask me?

• When did you first notice bleeding?
• How much blood is lost?
• Is the bleeding continuous, or does it come and go and come back again?
• Do you have a stomach ache?
• Have you had complications during previous pregnancies?
• Have you had uterine surgery before?
• Do you smoke or take drugs like cocaine?
• Is there someone to take care of you if you need bed rest?

When should I see my doctor?

If you experience bleeding, abdominal pain, or cramping during your pregnancy, especially in the second trimester, call your doctor immediately.

When should I go to the Emergency Department (ETU) ?

If you are bleeding heavily, seek emergency medical attention immediately. Heavy bleeding can cause serious side effects for both you and your baby.

Can I exercise with placenta previa?

Your doctor will probably tell you to limit certain activities, such as exercising, squatting, jumping, and lifting weights. These can cause bleeding. It's best to talk to your doctor about your daily routine and make changes as needed.

Can I have sex if I have placenta previa?

Many doctors recommend avoiding sexual intercourse if you have placenta previa. It's best to avoid things that can cause bleeding or uterine contractions, such as using tampons, douching, or inserting anything into the vagina.

Finally, take-home message:

Placenta Previa is a treatable condition. Many mothers with this condition go on to have healthy babies. If you follow your doctor's instructions carefully, you can have a safe delivery. If you experience any bleeding or discomfort during pregnancy, don't be afraid to tell your doctor. The safety of you and your baby is the most important thing. Placenta previa, pregnancy bleeding, cesarean section, cervix, pregnancy complications, ultrasound scan