It's normal for a mother to get worried about even the smallest things during pregnancy. Especially if your scan report says "low-lying placenta", or if you suddenly notice vaginal bleeding in the middle of your pregnancy, it can be very scary. So, don't panic. Today, we'll talk about this common fear of placenta previa, or what it is, is it really worth worrying about, and what to do in such a situation.
Simply put, what is placenta previa?
Imagine, when your baby is in your womb, he gets all the oxygen and nutrition he needs through an organ called the placenta. It's like a baby's lunch box. This placenta is connected to the baby through the umbilical cord, and it carries nutrients from you to the baby, as well as removing the baby's waste. This placenta develops inside the uterus.
Normally, this placenta is located in the upper part of the uterus, away from the opening (cervix) through which the baby comes out. The cervix is like the "door" through which the baby comes out.
Placenta previa is when the placenta, which is like a baby's lunchbox, is located at the bottom of the uterus, completely or partially covering the "door" (cervix).
Now imagine, when the baby is about to be born, that door (cervix) starts to open. Then, the delicate blood vessels connected to the placenta at the top of that door can tear. That's when heavy bleeding occurs, putting both the mother and the baby at risk. This is why doctors recommend a cesarean section (C-section) for mothers with this condition.
What are the main types of Placenta Previa?
This condition is not the same, there are several types. Depending on the type you have, the results may vary.
| Type | Simple meaning | Important points |
|---|---|---|
| Complete (Complete Previa) | The cervix (the doorway through which the baby comes in) is completely closed by the placenta. | In such a case, a cesarean section is definitely necessary. |
| Partial (Partial Previa) | The placenta is only partially covering the cervix. | A cesarean section is often necessary, and the decision is made based on the doctor's advice. |
| Marginal Previa / Low-lying | The placenta is located very close to the cervix, but it does not cover it. | This is the most common type. The good news is that in about 90% of cases, the placenta moves up on its own as the uterus enlarges. |
What are the symptoms of this condition?
Most of the time, mothers with Placenta Previa do not show any symptoms. It is detected during a routine scan. However, if symptoms do occur, they may include:
- The main symptom: Sudden, painless, light red vaginal bleeding in the second half of pregnancy (after 20 weeks). This can be light or heavy.
- Abdominal cramps: You may experience abdominal pain (contractions) as your bleeding progresses. It may feel like your stomach is tightening, or like a backache.
The important thing is that it is not normal to have vaginal bleeding at any time during pregnancy, especially in the second trimester. If you have a little bleeding, don't ignore it.
If you lose a lot of blood, you may also experience other symptoms of anemia, such as pale skin, a fast and weak pulse, difficulty breathing, and low blood pressure.
Who is at higher risk of developing Placenta Previa?
Although this condition can occur in anyone, some people are at higher risk.
- For mothers who smoke.
- For those who use drugs like cocaine.
- For those over 35 years old.
- If there have been several previous pregnancies.
- If you have had previous cesarean sections (C-sections) or other uterine surgeries (e.g., D&C).
- If you are pregnant with twins or triplets.
How do you find this, Doctor?
Most of the time, this is discovered by chance. Your doctor can see it during a routine scan during your pregnancy, especially during the anomaly scan, which is done around 20 weeks.
An ultrasound scan is used for this. First, you will be examined with an abdominal ultrasound. If that is not clear enough, your doctor may perform a small scan through the vagina (transvaginal ultrasound) to see more precisely where the placenta is located. There is no need to worry about it, it is a very safe test.
How is this treated?
The first thing to understand is that there is no cure or treatment for Placenta Previa, which is the condition where the placenta is in the lower part of the uterus. The main goal of treatment is to control bleeding and prolong the pregnancy until the baby is fully developed, which means closer to your due date.
Treatment depends on several factors:
- The amount of bleeding.
- Where are you at during your pregnancy?
- Your and your baby's health.
- The position of the placenta and the baby.
If bleeding is light (Light Bleeding)
If you have a small amount of bleeding, like a drop or two, your doctor will probably tell you to rest (bed rest) and to completely avoid strenuous activities, exercise, and sexual intercourse.
If there is heavy bleeding
If the bleeding is severe, it is an emergency. You will need to be hospitalized immediately. You will often be admitted to the Emergency Treatment Unit (ETU) and monitored closely. If necessary, you may even need a blood transfusion.
The doctor may also give you corticosteroid injections to help your baby's lungs develop faster. When your baby is about 36 weeks pregnant and feels it's safe to deliver, you'll schedule a planned C-section .
However, if the bleeding cannot be controlled, an emergency C-section may be necessary to save the mother's life, even if the baby is not fully developed.
When should I see a doctor immediately?
Remember this well.
If you experience any vaginal bleeding during the second or third trimester of pregnancy, whether it's light or heavy, call your doctor immediately.
If the bleeding is heavy, do not think about anything else and go to the nearest hospital immediately. Don't waste time.
Take-Home Message
- Placenta Previa is when the placenta is located low in the uterus, near or covering the birth canal (cervix).
- There are often no symptoms, but the main symptom is painless vaginal bleeding.
- This is usually diagnosed with an ultrasound scan.
- The goal of treatment is to control bleeding and maintain the pregnancy until the baby can be safely born (usually until 36-37 weeks) and then perform a cesarean section.
- See your doctor immediately for any bleeding that occurs during the second half of pregnancy. If it is heavy, go straight to the hospital.
- 90% of low-lying placenta cases resolve spontaneously as pregnancy progresses, so don't panic and follow your doctor's instructions.
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