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Placenta previa occurs when the placenta implants too close to the cervix, causing breakthrough bleeding and making vaginal delivery dangerous. It can be diagnosed with prenatal ultrasound and may require pelvic rest or bed rest. A C-section is usually recommended for delivery. Risk factors include age, smoking, and previous births.
Placenta previa is a complication that occurs in about one out of every 200 pregnancies carried to term. It is created when the placenta implants too close to the cervix, sometimes even partially covering the cervical opening. Because the uterus and cervix undergo changes in the latter stages of pregnancy to prepare for delivery, breakthrough bleeding can occur, and if placenta previa is still present at the onset of labor, vaginal delivery can be very dangerous.
There are three different types of placenta previa: marginal, partial, and complete. Marginal placenta previa occurs when the placenta is close to, but not covering, the cervix. The partial and complete types, as their names suggest, cover the cervix partially or completely.
In the first 20 weeks of pregnancy, placenta previa is sometimes diagnosed with a prenatal ultrasound. While it’s something to watch out for, it’s still not something to worry about, because sometimes the placenta grows in the upper part of the uterus, where the blood supply is most abundant, and the problem resolves itself. If this condition is diagnosed in the second half of pregnancy, however, it can be cause for concern.
Sometimes, a doctor notices the problem with a routine ultrasound, and other times it’s diagnosed after an expecting mother reports painless bleeding or spotting. As the time of delivery is much closer, the risks to mother and baby may increase. Women are usually placed on pelvic rest, which means there is no pelvic exam or intercourse, and can be encouraged to avoid heavy lifting. If breakthrough bleeding and placenta previa persist through the end of the third trimester, a mother may be placed on bed rest.
If placenta previa is present at the time of delivery, most doctors will recommend a C-section, which will allow them to deliver the baby or babies safely with a reduced risk of bleeding. If the breakthrough bleeding is severe in the last few weeks of pregnancy, an immediate C-section may be needed, even if the baby will be premature. The mother may require blood transfusions to compensate for the blood loss and will need to be monitored after delivery to make sure the bleeding has completely stopped.
Several factors can increase your risk of placenta previa, including age, smoking, a history of having the condition, twins and other multiples, and previous births. Like other pregnancy complications, this one is completely out of the mother’s control, although it can reduce some risk factors, which is why routine prenatal care to check for complications and potential problems with the birth is so important.
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