Ever heard of placenta previa? If you’re still clueless even if your OB-GYN tells you that you have placenta previa, you’re not alone. About 1 in 150 to about 1 in 300 patients are reported to have placenta previa – this makes it relatively uncommon. What is it? Is a C-section the only way to deliver? What are the causes, symptoms and the treatment available?
Definition of placenta previa
A normal birth means the baby is delivered first and the placenta comes after. Previa, coming from the word “praevia”, means “going before”. When the placenta is “before” the baby, it means that the placenta is situated lower than where it usually is in a normal pregnancy and it blocks the cervix. In other words, a placenta previa becomes an obstacle during delivery as it blocks the opening from which the baby has to pass through.
A placenta previa is usually diagnosed via a transvaginal ultrasonography.
Types of placenta previa
Placenta previa is further subdivided into the following 3 different categories depending on the extent to which it blocks the cervix:
- Complete (total) previa: The placenta is located directed at the opening of the cervix and blocks the entire cervical opening.
- Partial previa: The placenta only covers or obstructs part of the cervical opening.
Marginal previa: The cervix isn’t blocked, but the edge of the placenta is close to or is brushing the edge of the cervical opening.
When the placenta is lying low in the uterus but the edges of the placenta does not reach the internal os of the cervix, it is termed a “low-lying placenta” and the cervix is not blocked. A low-lying placenta is different from a placenta previa due to the fact that it doesn’t necessarily lead to a C-section and a vaginal birth is possible.
Placenta previa, be it complete, partial or marginal, might become an obstacle blocking the cervical opening which the baby has to pass through during a vaginal birth. If the cervix is blocked by the placenta, this can put the baby in danger during the delivery. Depending on the degree to which the cervical opening is covered by the placenta, the only viable way to deliver might be through a C-section.
Reasons why a placenta previa happens
The science of how and why a placenta previa occurs isn’t yet known. However, for reasons yet not discovered, in instances where the uterine lining becomes scarred or hurt, placenta previa occurs more easily. Other reasons include previous miscarriages or abortions, past C-sections, a past operation on the uterus, smoking, a multiple pregnancy, multiparity (having more than one child), or advanced maternal age (above 35). As there is no way to “treat” these possible contributing factors, there is no way to “heal” or “correct” a placenta previa.
Symptoms of a placenta previa
Before symptoms manifest, a 20-week scan might indicate to the practitioner that the placenta is located in the lower segment of the uterus. A transvaginal ultrasonography will be used to determine how serious the placenta previa is.
When your pregnancy progresses, symptoms will start to appear. The symptoms can be narrowed down to the following two symptoms: Bleeding without abdominal pain and bleeding profusely during check ups at the OB-GYN’s. In other words, what you need to worry about is bleeding that is painless.
Such symptoms usually start appearing from Week 29 onwards. So, if you notice any abnormal bleeding during that period, take note and notify your OB-GYN immediately. It’s possible for the placenta to move up as the weeks go by, so usually a placenta previa is confirmed before Week 33.
Mentally prepare yourself for sudden and heavy bleeding – to do so, you must remain calm. You might also have to go to the hospital, but medical treatment or surgery won’t necessarily “cure” the placenta previa. You might need to avoid moving about too much and rest more at home. This depends on what the doctor recommends to you, so try to take it easy and wait for further instruction.
Is a C-section a must if I have placenta previa?
In most cases, placenta previa pregnancies come to an end before the start of Week 39 through a C-section. If the baby is deemed ready for life outside the womb, a C-section can take place earlier than that. As there is usually heavy bleeding during a C-section delivery due to a placenta previa, stocking up on one’s own blood might start from around Week 34.
This is a safeguard against the possible huge loss in blood during delivery which can endanger the lives of both mother and baby. In instances where bleeding is severe and doesn’t stop, the whole uterus might have to be forcibly removed.
Delivering your baby in a situation where there are many risks mean that your baby might be at risk even after birth. Make sure you’ve been referred to a birthing center or a hospital with a neonatal intensive care unit (NICU) where there are professionals around who can respond to unforeseeable emergencies.
Be a step ahead
Feeling fearful or anxious because of a placenta previa is only natural. If there is a possibility of heavy bleeding and even the possibility of losing your whole uterus, no one will blame you if you give in to fear. However, remember that even the complications or possible negative outcomes are also just a possibility.
Be a step ahead and think of the different ways you can respond to this crisis and be in control of the situation. If you steel yourself mentally for whatever comes your way, you will be able to deal with it better!