The placenta is a vital organ that develops in the uterus during pregnancy. It nourishes and protects your baby by filtering away the wastes. It is usually attached to the top or side of the uterus by the umbilical cord. But sometimes, it is attached to the lower part of the uterus, resulting in a pregnancy complication known as placenta previa or low-lying placenta.
Here, MomJunction tells you what placenta previa is, how it affects your pregnancy, and how to rectify or manage it for a healthy and safe delivery.
What Is Placenta Previa?
Placenta previa is a pregnancy complication that occurs when the placenta lies low in the uterus and covers a part, or the entire cervix, which is the opening to the birth canal (1).
Placenta previa occurs in one out of 200 pregnancies (2). The condition is not a concern if it happens in the early stages of pregnancy. But if it occurs during labor and delivery, it could lead to complications that can harm both the mom and the baby.
What Are The Types of Placenta Previa?
- Marginal previa, where the placenta borders the cervix
- Partial previa, where the placenta covers only a part of the cervical opening
- Complete previa, where the placenta covers the cervix entirely
The condition can be further classified into anterior and posterior placenta previa, which refers to the exact placental position within the uterus. It can be defined through an ultrasound scan (3) (4).
What Are The Causes Of Placenta Previa?
The actual cause of placenta previa is unknown. But some factors can increase the likelihood of this condition (5).
Risk factors that increase the chances of a low-lying placenta include:
- Previous surgeries of the uterus, such as a C-section, D&C (dilation and curettage) or uterine fibroid removal
- Second or subsequent pregnancy
- Advanced maternal age
- Carrying twins, triplets or more
These risks cannot be controlled. Others that can be controlled to prevent placenta previa include:
- Cocaine consumption
Knowing the symptoms of this condition could help in an early diagnosis.
What Are The Symptoms and Signs Of Placenta Previa?
The signs and symptoms of placenta previa differ from one pregnant woman to another. While some do not experience any symptoms, others show warning signs such as (6):
- Sudden onset of painless, bright red vaginal bleeding that can range from light to heavy.
- Early labor symptoms such as regular contractions, pain in the belly, or lower back.
You must call your doctor immediately if you notice vaginal bleeding during your pregnancy, irrespective of the trimester.
Here are other symptoms that indicate placenta previa, but can only be detected through an ultrasound scan:
- The baby is in a breech or transverse position because the placenta occupies most of the cervix, preventing the baby to move into a head-down position
- The uterus measures larger than it should at the given gestational age.
If you do not experience any symptoms, your doctor may be able to identify a placenta previa during your regular prenatal scans.
How Is Placenta Previa Diagnosed?
Placenta previa can be diagnosed during a prenatal checkup or after a bout of vaginal bleeding. Most cases are detected during the second-trimester checkup when you have a routine ultrasound test. The diagnostic tests include (7):
- Ultrasound scan
- Feeling the belly to detect the position of the baby
- A combination of abdominal and transvaginal ultrasounds, in some cases
If your doctor detects placenta previa, they will avoid any further vaginal examinations to lower the risk of bleeding, except when there is an urgent need for a cesarean section.
Here are some questions your doctor may ask to confirm the diagnosis:
- When did you first notice vaginal bleeding?
- Was the bleeding only once, or was it recurring?
- Do you have any pain or contractions?
- Is the bleeding heavy?
- Did you undergo any surgeries such as fibroid removal, cesarean, D&C, or abortion?
- Is this your first pregnancy?
- How long does it take to reach the hospital in case of an emergency?
- Do you smoke?
- Is there anyone who can accompany you when required?
If the diagnosis is confirmed, you can ask your doctor these questions:
- Is there a chance of the condition resolving on its own?
- How do I take care of myself?
- How can I manage the bleeding?
- What symptoms should prompt me to go to the hospital?
- When should I revisit the hospital?
- Will a placenta previa increase the chances of complications in future pregnancies?
- Can I deliver vaginally?
In addition to this, your doctor may also give you care instructions and precautions to take when you have a placenta previa.
How Is Placenta Previa Treated?
Management and treatment depend on some factors:
- The health of the mother and the baby
- The position of the baby
- The location of the placenta
- The amount of blood loss
- The gestational age of the baby
- The type of placenta previa
You may require bed rest or hospital stay and blood transfusion if there is severe blood loss. Your doctor may suggest early delivery. Cesarean section delivery is usually recommended (8).
What To Do When
You are not bleeding or bleeding lightly
- Be prepared to go to the hospital if bleeding turns heavy or resumes.
- If the placenta is placed low but is not covering the cervix, your doctor may suggest a vaginal delivery.
You are bleeding heavily
- Go to the doctor immediately as blood transfusion may be necessary in the case of severe bleeding.
- The doctor prescribes steroids if you are not nearing the due date, or haven’t reached the 36th week, to prepare the baby by speeding up the development of his or her lungs.
- The OB/GYN will plan a cesarean if you are past the 36th week.
Your bleeding does not stop
- Emergency cesarean, even if you are not nearing the due date.
These are situations when you need to visit the doctor immediately, to prevent any harm to you or your baby.
Sometimes, a low-lying placenta can be managed with the help of alternative treatments. More about it next.
Alternative Therapies For Low-Lying Placenta
In most cases, placenta previa resolves on its own as the pregnancy advances, and the uterus enlarges. A low-lying placenta diagnosed during the second trimester resolves by the mid-third trimester (9). In very rare cases, it can persist up to term and requires medical intervention in the form of cesarean delivery.
If you are planning for a natural birth, you may try to manage the condition with natural treatment options, such as Traditional Chinese Medicine (TCM).
TCM sees placenta previa as Sinking Qi, and the aim of the treatment is to raise this Qi, curb vaginal bleeding, and calm the baby inside. It uses a combination of two techniques – herbal medicines and acupuncture (10).
- Herbal remedies: Bu Zhong Yi Qi Tang is an herbal formula designed for treating this placental condition. It raises the Qi and is a safe medicine for pregnancy.
- Acupuncture: Du 20 is the key point useful for treating placenta previa. It is located at the top of the head and is very effective in raising the Qi.
If you wish to try the TCM treatment, make sure to choose a qualified practitioner for it.
Irrespective of whether it is a conventional or alternative treatment, you need to take some measures to keep your pregnancy safe.
Precautions For Low-Lying Placenta
These precautions help you avoid further complications caused by a low-lying placenta (1).
- Avoid strenuous activities, such as intense cardio exercise or lifting weights
- Avoid sexual intercourse
- Take bed rest
Precautions are important because placenta previa can lead to some serious complications.
What Are The Complications Of Placenta Previa?
Some possible complications of placenta previa include (4):
- Hemorrhage (heavy bleeding)
- Fetal distress from lack of sufficient oxygen
- Premature birth that is before the 37th week of pregnancy
- Birth defects
- Slowed baby growth
- Health risks to the baby
- Emergency C-section
- Hysterectomy, when the placenta fails to deliver from the uterine lining
- Placenta accreta, where the placenta attaches deep into the uterine wall
While you cannot correct a low-lying placenta, you can manage the condition. Next, we’ll tell you how.
How To Cope With Placenta Previa?
Here is how you can do it:
- Learn everything about the condition: Having clarity about the condition eliminates unwanted doubts, fears, and anxiety. Try researching on your own, talk to your doctor or connect with others (you can find in support groups) who have the same condition.
- Prepare for cesarean section: Placenta previa makes normal vaginal delivery difficult. So, a cesarean section will become necessary for your baby’s and your well-being.
- Self-care: Indulge in activities such as listening to your favorite music or reading a book to calm yourself down. Ask your partner or your loved one to help you in preparing your favorite dish or visiting a pleasant place.
- Take rest: You may not like the idea of bed rest, but you need it at this time. Use the free time to pursue a hobby or read about baby care and shop online.
How To Prevent Placenta Previa?
There is no way to prevent placenta previa since there is no particular cause for it.
However, if the risks for you are high owing to your age, prior surgeries, or previous pregnancies, try to be extra careful and maintain a healthy lifestyle. Most importantly, stay away from cigarette smoking and cocaine consumption as they are associated with the condition.
Next, we answer a few commonly asked questions about placenta previa.
Frequently Asked Questions
1. Is placenta previa genetic (hereditary)?
No, placenta previa is an obstetric complication and not a genetic condition (1).
2. Can I fly with a low-lying placenta?
Avoid flying as it can increase the risk of bleeding and other pregnancy complications. These complications could develop due to the turbulence and sudden movements during the flight.
Placenta previa could be a stressful diagnosis, which could fill you with fear and anxiety until delivery. But the good news is that it can be managed for a smooth delivery without complications. So do not worry about the condition but talk to your doctor if you have any concerns about it.
Do you have any experiences to share? Please tell us about them in the comments section below.
2. Mabie WC; Placenta previa; Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
3. Shumaila Zia; Placental location and pregnancy outcome; J Turkish-German Gynecol Assoc 2013
4. Frances M. Anderson-Bagga and Angelica Sze.; Placenta Previa
5. a href=”https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02437″>Placenta Previa; The University of Rochester Medical Center
6. Robert K. Stoelting, et al.; Placenta Previa; Stoelting’s Anesthesia and Co-existing Disease
7. Bleeding in Pregnancy/Placenta Previa/Placental Abruption; The Children’s Hospital of Philadelphia
8. Placenta Previa; Stanford Children’s Health
9. Heller HT, et al.; Outcomes of pregnancies with a low-lying placenta diagnosed on second-trimester sonography
10 .Bob Flaws; Chinese Medical Obstetrics