The risks of placenta Previa in pregnancy

Emobileclinic Trending Topic : Placenta Previa

Placenta previa is a medical condition when the organ joining the fetus to the uterus (placenta) is attached so low in the uterus that it partially or totally blocks the opening of the uterus (cervix). The condition varies in severity, depending on how close the placenta is to the cervix. There are Most pregnant women with multiple gestations are more likely to develop placenta previa, although, the reason for this ambiguous.

Also, women are more likely to suffer from placenta previa if they have had previous pregnancy terminations and/or cesarean sections, a previous diagnosis of placenta previa, or erythroblastosis.

Types

There are three types of placenta previa: 

Complete or total: situation where the placenta covers the entire opening to the cervix

Partial: where the placental covers the opening to the cervix partially covered

Marginal: where the placenta almost touches the edge of the opening to the cervix.

Risk Factors

Age: pregnant women above the age of 40 are at greater risk of having placenta previa

Surgical history: women who had cesarean section 

Risky lifestyle: women who smoke and take alcohol have high risk of developing placenta previa.

History: painless second or third-trimester bleeding (hemorrhage) is the primary sign of placenta previa. Although there may be some spotting of blood early in the pregnancy, the first episode of hemorrhage usually begins sometime after the twenty-eighth week of pregnancy. Caused by placental tissue separating from the uterus, the bleeding is sudden, painless, and profuse. There may be some cramping.

Physical examination: the uterus is usually soft, relaxed, and non-tender. A digital exam is not done as it may cause more bleeding. Most cases of placenta previa turn up during routine ultrasound exams.

Tests: ultrasound is then used to view the placement of the placenta in the uterus. Ultrasound is correct 95% of the time if done through the abdomen and 100% of the time if done through the vagina

Full blood count (CBC) and coagulation studies such as prothrombin time (PT), active partial thromboplastin time (aPTT), fibrin split products, and fibrinogen can rule out disseminated intravascular coagulation. Placenta increta, placenta percreta, and placenta accreta can be ruled out by MRI.

Treatment

The treatment depends on the quantity of bleeding, the gestational age, ability of the fetus to survive, the extent of the placenta covering of the cervix, and whether or not labor has begun. Hospitalization is mandatory until it is certain the condition of the mother and fetus is stable. Major blood loss is replaced by transfusions. Tocolytic medication should be given to prevent premature labor and to prolong pregnancy until at least 36 weeks, unless abruptio placentae have been diagnosed.

Cesarean section is the delivery method used in most cases because it presents the least risk to the mother and fetus. Vaginal delivery is only used if the placental placement is high enough in the uterus and the fetus is presenting headfirst (cephalic presentation), or if there is no chance of the fetus surviving. Regular prenatal visits to a physician or maternity clinic are essential for a healthy, safe pregnancy, delivery and postpartum period.

Looking Forward

For the mother who has access to transfusions, antibiotics, and cesarean section delivery, the outcome is excellent. Half of females with the disorder have premature labor, and there is a 2% to 3% death rate for the fetus (Joy). Fetuses can also have anemia, genetic disorders, and difficulty breathing. However, these problems may be greatly reduced by early intervention and aggressive care both before and after birth.