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Placenta Praevia

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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