What Does It Mean To Have Placenta Previa Or Low Lying Placenta? Symptoms, Causes And Treatments

Placenta previa is a rare pregnancy complication in which the placenta abnormally gets implanted in the lower segment of the uterus, partially or totally covering the cervix.

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The cervix is a part of the female reproductive system, which is 2-3 cm long, cylindrical in shape and connects the vagina and uterus. It is the lower end of the uterus. The cervix allows the baby to pass from the uterus into the vagina to be delivered.

The prevalence of placenta previa is around four per 1000 births.

Take a look at more details of placenta previa.

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What Does It Mean To Have Placenta Previa?

When the fertilised egg implants itself to the wall of the uterus, the placenta starts to form. The location of the implantation of the egg could be the top, front, back or the sides of the uterus.

Usually, the placenta attaches itself to the upper part of the uterus, but when it is attached to the lower segment, it is called placenta previa or low-lying placenta. [1]

As the placenta physically blocks the cervix or birth canal in placenta previa, the risk of bleeding during pregnancy may increase, including the chances of caesarean delivery. [2]

The incidences of cesarean sections in the past 50 years have increased. A study has shown that C-section delivery could possibly be an important risk factor in the development of the low-lying placenta. Also, with every cesarean section, the risk of placenta previa increases for the next pregnancy. [3]

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Is Placenta Previa Different From Low-Lying Placenta?

There's a bit of difference between placenta previa and low-lying placenta. When the placenta is close to covering, but is not actually fully covering the cervical opening, it is called the low-lying placenta. In this case, the distance between the edge of the placenta and cervix could be less than 2 mm.

Studies say in around 90 per cent of cases, the low-lying placenta gets resolved by the third trimester due to placental migration or due to growth and stretch of the uterus, even if there is a history of caesarean section. [4]

Placenta previa is when the placenta completely covers the cervix. In such a case, the risk of placental migration is less.

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What Are The Symptoms Of Placenta Previa?

Some of the symptoms of placenta previa may include:

• Bleeding after intercourse, during labour or vaginal examination.
• Sudden cramps or stomach pain.
• Light to heavy bleeding that begins and stops and starts again after a few days or weeks.
• Red bright bleeding without pain, especially during the second or third trimester.
• In rare cases, contractions are felt.

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Causes And Risk Factors For Placenta Previa

There is no exact cause for the development of placenta previa, however, there are certain risk factors that are likely to cause the condition. They include: [5]

• Advanced maternal age or age greater than 35 years.
• Previous incidence of uterus surgery, could be due to C-section delivery or fibroids or curettage.
• Multiparity or have given birth one or more times.
• Tobacco smoking or use of illicit drugs.
• Have had pregnancy through IVF.
• Being pregnant with two or more babies.
• History of miscarriage.
• Having abnormal-shaped uterus
• Having large placenta size.
• Having a previous history of placenta previa.

Complications Of Placenta Previa

If placenta previa is not treated or managed well during the delivery, it may cause complications like severe vaginal bleeding, which may lead to emergency C-section delivery. This may also result in preterm delivery.

Other complications may include postpartum haemorrhage [6], hypovolemic shock and intrapartum haemorrhage

Diagnosis Of Placenta Previa

Routine sonography can help detect or diagnose placenta previa during the first or second trimester of pregnancy. In such as condition, a medical expert may advise for timely follow-ups to evaluate whether the placenta has migrated away from the cervix or not or is persistent. [7]

If the placenta is persistent at the cervical canal, a doctor often advises for caesarean delivery with safety measures.

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Treatments Of Placenta Previa

If a pregnant woman with placenta previa has reached close to her due date and is experiencing bleeding due to the condition, a doctor may suggest immediate C-section delivery. [8]

If there's still time to reach the delivery date, a medical expert may suggest pelvic rest, abstaining from intercourse and avoidance of vaginal douches. They may increase the fetal monitoring and manage early labour with medications, at least till 36 weeks.

Some patients may receive medications like steroids for the lung maturity of the fetus and magnesium sulfate for its neuroprotection. [9]

Patients with the low-lying placenta can opt for vaginal delivery, if a medical expert suggests the same. The delivery can be carried out with limited morbidity and only if the distance between the placenta and cervix is 1-2 cms. [10]

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To Conclude

Placenta previa can be alarming for expectant mothers. Experts say that educating the patients with the condition can help lower their stress and manage the gestation effectively with suggested measures. Also, it is good to never miss on follow-ups so that placenta previa can be diagnosed early, if exists, and be managed for safe delivery.