What is placenta praevia
This may sound like the name of a
disease, but it is a term used to describe a low-lying placenta. It actually
refers to the position, and not the condition of the placenta. In placenta
praevia, the placenta is attached to the lower half of the uterus, covering,
partially covering, or touching the edge of the os (the mouth of the uterus).
While this is fairly common in the early stages of pregnancy, the placenta
is supposed to move upwards as the pregnancy progresses.
What are the risks associated with placenta praevia
Placenta praevia can cause problems
later in the pregnancy and at the time of delivery. The closer to the os
the placenta is situated, the greater the chances of haemorrhage. Foetuses
with low-lying placentas do not usually 'drop' into the pelvis in preparation
for delivery as the placenta blocks their way. Vaginal delivery may become
impossible if the placenta blocks the cervix partially or completely.
What are the symptoms of placenta praevia
This complication occurs in only
1% or less of full-term pregnancies. The most common sign of placenta praevia
is painless bleeding that occurs prior to the onset of labour and that
stops of its own accord. The bleeding occurs as a result of the cervix
stretching before and during labour. The bleeding is bright red and occurs
spontaneously. It may be triggered by sexual intercourse, straining or
coughing. However, an estimated 7% to 30% of women with low-lying placentas
do not bleed at all before delivery. In cases like this, this condition
may be discovered at the time of conducting a routine ultrasound examination
or even at the time of delivery.
How do I deal with placenta praevia
This condition does not need to be
treated until the 20th week of pregnancy. Sometimes women who have been
diagnosed with placenta praevia do not display any symptoms. In such cases,
the doctors usually advise them to cut down on their activities and increase
their hours of bed rest. If the woman is bleeding, she must be hospitalized
to evaluate the condition of both the mother and the baby. She will probably
be confined to her bed and closely monitored until the time of delivery.
The aim is to keep the pregnancy going for at least 37 weeks. By this time,
the lungs of the foetus should have developed sufficiently for the doctor
to safely perform a caesarian section to prevent massive haemorrhaging.
Will it be possible to have a normal delivery
Sometimes the placenta lies next
to or near the cervix, but does not cover it wholly or partially. In such
a case, the obstetrician can conduct a vaginal examination to determine
the exact location of the placenta. He can then better calculate the risks
of bleeding in a vaginal delivery. Statistics show that approximately 3
in 4 women who have been diagnosed with this condition will have to undergo
a caesarian section before the commencement of labour. However, if the
condition is discovered after labour has begun, the placenta is not blocking
the cervix and the bleeding is mild, a normal vaginal delivery may be attempted.
Who are the potential candidates for developing placenta praevia
High-risk candidates include those women whose uterine walls have been scarred from previous pregnancies, caesarians, uterine surgery or D & Cs following miscarriage. Smoking, living at a high altitude or carrying more than one foetus also increases the probability of the occurrence of placenta praevia.
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