By the way, if you have bleeding and you're Rh-negative , you'll need a shot of Rh immune globulin, unless the baby's father is Rh-negative, too. When it's time to deliver, you'll need a c-section. With a complete previa, the placenta blocks the baby's way out. And even if the placenta is only bordering the cervix, you'll still need to deliver by c-section in most cases because the placenta can bleed profusely as the cervix dilates.
When you deliver will depend on how far along you are in your pregnancy, how heavy your bleeding is, and how you and your baby are doing. Your baby will need to be delivered immediately if he's not doing well or if you have heavy bleeding that doesn't stop.
Otherwise, you'll be watched in the hospital until the bleeding stops. You may be given medication to speed up your baby's lung development and to prevent other complications in case he ends up being delivered prematurely. If the bleeding stops for at least a couple of days — and you and your baby are in good condition and you have quick access to a hospital — you may be sent home.
But it's common for the bleeding to start again at some point and, when this happens, you'll need to return to the hospital immediately. If you and your baby continue to do well, you'll have a scheduled c-section at around 37 weeks. When making the decision, your medical team will weigh the benefit of giving your baby extra time to mature against the risk of waiting, with the possibility of facing an episode of heavy bleeding and the need for an emergency c-section.
Heavy bleeding. Having placenta previa makes it more likely that you'll have heavy bleeding and need a blood transfusion. This can even happen after the placenta is delivered because it was implanted in the lower part of the uterus, which doesn't contract as well as the upper part — so postpartum contractions aren't as effective at stopping the bleeding.
Placenta accreta. Women who have placenta previa are also more likely to have a placenta that's implanted too deeply and that doesn't separate easily at delivery. This is called placenta accreta and it can cause massive bleeding and the need for multiple blood transfusions at delivery. It can be life threatening and may require a hysterectomy to control the bleeding.
Premature birth. If you need to deliver before term, your baby will be at risk for complications from premature birth , such as breathing problems and low birth weight. Future preterm birth. There's also some evidence that women with placenta previa who deliver preterm especially before 34 weeks are at increased risk for preterm birth in future deliveries. Most women who develop placenta previa have no apparent risk factors. But if any of the following apply to you, you're more likely to have it:.
In vasa previa, some of the fetal blood vessels are exposed and cross over the cervical opening, instead of being contained in the umbilical cord. When contractions happen, these blood vessels stretch and may rupture, resulting in catastrophic fetal blood loss and fetal distress.
This is a very serious condition and may require prolonged monitoring in the hospital. BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals.
We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies. Anderson-Bagga FM et al. By the third trimester , the placenta should be near the top of the womb. This position allows the cervix, or the entrance to the womb at the bottom of the uterus, a clear path for delivery.
When the placenta covers the cervical os during the last months of pregnancy, the condition is known as placenta previa. Most pregnant people with placenta previa will require pelvic rest. This typically includes abstaining from having sexual intercourse, limiting any procedures like an obstetrical check for dilation, and possibly restricting any exercises that may strain the pelvic floor.
The main symptom of placenta previa is sudden light to heavy bleeding from the vagina. Any bleeding can be representative of problems with the placenta and needs investigation by a physician. Specific symptoms may include:. Pregnant people who are smokers, who are older than 35, or who are of Asian descent are also at higher risk of developing placenta previa. Usually, the first signs of placenta previa will show up during the routine week ultrasound. These initial signs are not necessarily a cause for worry, since the placenta is often lower in the uterus during the early part of a pregnancy.
The placenta usually corrects itself. According to the Royal College of Obstetricians and Gynaecologists , only 10 percent of people with low-lying placenta at 20 weeks will have a low-lying placenta at their next ultrasound.
If you experience any bleeding in the second half of your pregnancy, doctors will monitor the position of the placenta using one of these preferred methods:. For cases of placenta previa with minimal or no bleeding, your doctor will likely suggest pelvic rest. This means refraining from putting anything into your vagina during pregnancy in order to prevent medical complications.
If bleeding occurs during this time, you should seek medical care as soon as possible. If the C-section needs to be scheduled sooner, your baby may be given corticosteroid injections to speed up their lung growth. During labor, the cervix will open to allow the baby to move into the vaginal canal for birth. If the placenta is in front of the cervix, it will begin to separate as the cervix opens, causing internal bleeding.
Home Healthy pregnancy. Placenta previa. Actions for this page Listen Print. Summary Read the full fact sheet. On this page. Symptoms Why the bleeding happens Possible complications Causes and risk factors Diagnosis methods Digital vaginal examinations should be strictly avoided Treatment options vary Treatment during pregnancy Delivery Where to get help Things to remember.
Symptoms The most important symptom in placenta previa is painless vaginal bleeding after 20 weeks. Why the bleeding happens During the later stages of pregnancy, the bottom part of the uterus thins and spreads to accommodate the growing baby. Possible complications Some of the complications of placenta previa include: Major haemorrhage bleeding for the mother Shock from loss of blood Fetal distress from lack of oxygen Premature labour or delivery Health risks to the baby, if born prematurely Emergency caesarean delivery Hysterectomy, if the placenta fails to come away from the uterine lining Blood loss for the baby Death.
Causes and risk factors Some of the possible causes and risk factors of placenta previa include: Low implantation of the fertilised egg Abnormalities of the uterine lining, such as fibroids Scarring of the uterine lining endometrium Abnormalities of the placenta Multiple babies, such as twins Multiple pregnancies - a woman who has already had six or more deliveries has a risk of one in Diagnosis methods A pregnant woman who experiences any vaginal bleeding should be admitted to hospital and tested.
Digital vaginal examinations should be strictly avoided It is sometimes difficult to tell the difference between placenta previa and placental abruption. Treatment options vary Treatment depends on a number of factors, including: Whether the placenta previa is complete or partial The exact location of the placenta The amount of blood lost The gestational age of the baby The position of the baby The health of the baby The health of the mother.
Treatment during pregnancy Medical treatment aims to ease the symptoms and prolong the pregnancy. Options may include: Bed rest.
Blood transfusion for the mother. Avoiding any activity that triggers uterine contractions or irritates the cervix, such as sexual intercourse or orgasms.
Delivery Once the baby is old enough to be delivered, a caesarean section is usually performed. Where to get help Your doctor Obstetrician Emergency department of your nearest hospital Always call an ambulance in an emergency Tel. Treatment aims to ease the symptoms and prolong the pregnancy until at least 36 weeks.
Eds R. Berkow, M. Beers, A.
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