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Placenta Previa

Normally, the placenta covers the top of the uterus, but if you develop placenta previa, the placenta partially covers the cervix. One out of every 200 to 250 pregnancies are affected by this condition, with varying severity. The cervix may be completely (called a complete or total previa), partially, or only marginally covered by the placenta.

Most cases of placenta previa correct themselves as the pregnancy progresses; however, in approximately ten percent of cases, the placenta previa is still present at term, which can cause complications. Babies can suffer blood loss, intrauterine growth retardation due to the placenta's inability to provide optimal nutrition, or congenital anomalies. Moms can be at higher risk for hemorrhages, cesarean delivery, or placental invasion, which requires a hysterectomy.

Placenta previa most commonly affects older pregnant women, women who smoke, those who have given birth many times before or are pregnant with multiples, or women who had placenta previa in an earlier pregnancy or have had previous uterine surgery, like a cesarean section or an abortion. Many women alert their caregivers to their placenta previa when they report painless bleeding in their second or third trimester. The bleeding may be light or heavy, and may stop suddenly, but generally reappears. Other common indications include premature contractions, an abnormal positioning of the baby, and the uterus measuring larger than normal. If these symptoms are present, your doctor does an ultrasound to identify or rule out placenta previa. Very rarely, a vaginal exam is performed, usually in an operating room, with a medical team at the ready to perform a cesarean section in case of hemorrhaging.

If you are diagnosed with placenta previa but not bleeding, your doctor will probably give the baby more time to mature and diagnose bed rest and the use of extreme care in the vaginal area, avoiding tampons, intercourse, douching, etc. If you begin to bleed, your doctor will evaluate your baby's lungs in case an emergency cesarean is required, and you will be put through blood tests. Your blood loss will be studied and a transfusion will be prepared for. If your baby is not quite ready to meet the world, your doctor will probably give your baby a steroid injection to promote the growth of your baby's lungs, and you will be given intravenous fluids and oxygen to make sure that both you and your baby do not suffer as a result of the blood loss.

Most women diagnosed with placenta previa have caesarian deliveries to prevent uncontrolled bleeding. Some mothers with marginal previa may deliver vaginally, but no matter how your baby is delivered, their prognosis will be good with proper care and as much time to mature as possible.


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