Placenta previa is a condition when the placenta is in the lower part of the uterus, thus covering part or all of the birth canal. In addition to blocking the birth canal, placenta previa can cause heavy bleeding, both before and during delivery.
The placenta is an organ that forms in the uterus during pregnancy. This organ functions to distribute oxygen and nutrients from the mother to the fetus, and remove waste from the fetus.
Normally, the placenta is located at the bottom of the uterus at the beginning of pregnancy, but as the gestational age increases and the uterus grows, the placenta will move upwards. In the case of placenta previa, the position of the placenta does not move from under the uterus until near the time of delivery.
SymptomPlacenta Previa
The main symptom of placenta previa is vaginal bleeding that occurs in the late second or early third trimester of pregnancy. Bleeding can be heavy or light, and will recur in a few days. Not infrequently this condition is considered menstruation during pregnancy. The bleeding can also appear after sex and is accompanied by contractions or abdominal cramps.
When to go to the doctor
Immediately consult a gynecologist if there are spots or bleeding during pregnancy.
Cause and Risk Factors for Placenta Previa
The exact cause of placenta previa is not known, but there are several factors that are thought to make pregnant women more at risk of suffering from this condition, namely:
- 35 years or older.
- Smoking while pregnant or abusing cocaine.
- Have an abnormal shape of the uterus.
- Not the first pregnancy.
- Previous pregnancies also had placenta previa.
- Abnormal fetal position, such as breech or transverse.
- Pregnant with twins.
- Never had a miscarriage.
- Have had surgery on the uterus, such as a curettage, fibroid removal, or caesarean section.
Diagnosis of Placenta Previa
Doctors can suspect that a pregnant woman has placenta previa if bleeding occurs in the second or third trimester of pregnancy. However, to be sure, the doctor will perform the following tests:
- Transvaginal ultrasound
This procedure is done by inserting a special tool into the vagina to see the condition of the vagina and uterus. This examination is the most accurate method for determining the location of the placenta.
- Pelvic ultrasound
This procedure is the same as a transvaginal ultrasound, but the device is only attached to the abdominal wall, to see conditions inside the uterus.
- MRI (magnetic resonance imaging)
This procedure is used to help doctors see clearly the position of the placenta.
If a pregnant woman experiences placenta previa, the obstetrician will continue to monitor the position of the placenta or placenta with ultrasound periodically, until the day of delivery arrives.
Treatment Placenta Previa
Treatment of placenta previa aims to prevent bleeding. The treatment that will be given by the doctor depends on the health condition of the mother and fetus, gestational age, position of the placenta, and the severity of bleeding.
For pregnant women who do not experience bleeding or only experience light bleeding, doctors will usually allow pregnant women to carry out independent treatment at home, in the form of:
- Lying a lot
- Avoid sports
- Avoid intercourse
Although not requiring hospitalization, patients should still be alert and seek medical attention immediately if bleeding worsens or does not stop.
If a pregnant woman experiences heavy or recurrent bleeding, the obstetrician will recommend that the baby be delivered as soon as possible by caesarean section. However, if the gestational age is less than 36 weeks, pregnant women will be given an injection of corticosteroid drugs first to accelerate the maturation of the fetal lungs. If necessary, pregnant women will also be given blood transfusions to replace lost blood.
Pregnant women who experience placenta previa can actually still give birth normally, as long as the location of the placenta does not cover the birth canal or only partially covers it. But if the placenta covers the entire birth canal, the doctor will suggest a cesarean section.
Complications of Placenta Previa
Placenta previa can be dangerous for both the mother and the fetus. In the mother, placenta previa can cause complications such as:
- Shock
Shock occurs due to heavy bleeding during labor.
- Blood clotting
This complication occurs due to hospitalization that makes the mother lie down for too long, so the blood is easier
While in the fetus, complications that can occur due to placenta previa are:
- Premature birth
If bleeding continues, the baby should be delivered by caesarean section immediately, even if it is not yet full term.
- Fetal asphyxia
This condition occurs when the fetus does not get enough oxygen while in the womb.
In rare cases, placenta previa can cause placental tissue to grow too deep, making it difficult to expel (placental retention). This condition will worsen the bleeding.