WHAT IS PLACENTA PREVIA?

Bleeding in late pregnancy, due to a low-lying placenta, covering the cervix (pic). This bleeding can be life threatening to the unborn child. It occurs to some degree in 1 of 200 pregnancies.

SIGNS & SYMPTOMS

• Sudden, painless bleeding during the second or third trimester of pregnancy--especially the last 13 weeks. Bleeding may begin moderately and become severe.
• Abnormal position of the fetus in the uterus.

CAUSES

Normally, placenta attaches high on the uterus wall, away from the cervix. In placenta previa, the placenta covers the cervix partially or completely. Any change in the cervix, such as the softening and dilating that occurs close to delivery, can cause the placenta to separate from the uterus and bleed.

RISK INCREASES WITH

• Fibroids of the uterus.
• Diabetes mellitus.
• Previous uterine surgery.
• Multiple previous pregnancies and deliveries.
• Mothers over age 35.

DIAGNOSTIC MEASURES

• Vaginal bleeding during pregnancy.
• Ultrasonography done early in the pregnancy may give some clue and a proper follow-up can be done later.

POSSIBLE COMPLICATIONS

• Premature delivery or fetal death, if extensive placenta previa develops before the expected delivery date.
• Hazardous blood loss, requiring blood transfusions for the mother.

PROBABLE OUTCOME

With prompt care, mothers and most infants survive without complications. In some cases, delivery is necessary before the fetus is mature enough to survive.

TREATMENT

GENERAL MEASURES

Have regular checkups during pregnancy. If signs of placenta previa appear, be prepared to go to the hospital early for observation and possible delivery. Plan delivery at a hospital close by and arrange for quick mode of transportation to the hospital in case of emergency, especially massive bleeding.

A marginal placenta previa requires bed rest in the hospital until bleeding stops. If bleeding stops, one may get up-but should stay in the hospital until delivery. Leaving the hospital may put your life and that of your child at risk. Massive bleeding can occur before one can get back to the hospital.

If you are near the expected delivery date and studies reveal more than a marginal or low-lying placenta, immediate Cesarean section is necessary-even though the child is below optimal size and development.

Don't use aspirin during pregnancy - it increases the risk of bleeding.

ACTIVITY

Rest in bed until bleeding stops or you deliver your child.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

• You have symptoms of placenta previa.
• Report any bleeding immediately.
• This is an emergency!