Placenta Previa: What Is It And How Does It Affect A Pregnancy?

What Is Placenta Previa And How Does It Affect A Pregnancy?

April 6, 2021 Updated July 1, 2021

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Omurden Cengiz/Unsplash

Teenagers get a bad rap for doing their own thing and being unpredictable, but have you ever tried coordinating with a fetus? Basically, from the moment your womb’s newest resident shows up, they’re the ones in control. Think you have a say in when you’re going to pee? Not a chance! Plan a babymoon? You know that fetus is going to do at least something to remind you that they’re on the trip with you during this pregnancy — perhaps even during an intimate but inopportune moment with your partner. Think you’re going to give birth on your “due date“? Unless you get induced, the only one calling the shots regarding their grand entrance into the world is — you guessed it — that little nugget.

This can also include where the fetus decides to lounge inside the uterus. Sometimes the location they pick isn’t ideal — for example, situated in a low-lying placenta, also known as “placenta previa.” Here’s what to know about placenta previa, including the definition, symptoms during pregnancy, treatment options, and whether it’s harmful to the baby.

RELATED: What Happens During Placental Abruption In Pregnancy?

What is placenta previa?

Placenta previa, by definition, is when the placenta grows lower down in the uterus than usual — including in situations where it covers all or part of the cervix, according to MedlinePlus. The condition occurs in one out of 200 pregnancies.

There are four different types  — or “grades” — of placenta previa:

  • Grade 1: The placenta sits low in the uterus.
  • Grade 2: Marginal previa, or when the placenta is next to the cervix but not covering the opening.
  • Grade 3: Partial previa, or when the placenta covers part of the cervical opening. During this time there’s even more focus on the baby. Amniotic fluid levels are checked regularly to ensure the fetus is getting all the nutrients it needs.
  • Grade 4: Complete previa, or when the placenta covers the entire cervical opening.

The main placenta previa symptoms are sudden (and often bright red) vaginal bleeding in the second half of pregnancy, and contractions. There’s not really a standard of how often you bleed with placenta previa. For some, the bleeding could last a few days, then go away on its own, and then return a few days or weeks later. For those nearing the end of their term, heavy bleeding typically begins a few days before going into labor.

What can cause placenta previa?

Like other problems with the placenta, doctors aren’t sure what, exactly, can cause placenta previa. They do, however, know that people in the following groups are at higher risk (per the Mayo Clinic):

  • Those who’ve had a baby
  • Have scars on the uterus, such as from previous surgery, including cesarean deliveries, uterine fibroid removal, and dilation and curettage
  • Had placenta previa with a previous pregnancy
  • Are carrying more than one fetus
  • Are age 35 or older
  • Are of a race other than white
  • Smoke
  • Use cocaine

Placenta previa is most commonly diagnosed via ultrasound, either during routine prenatal care visits or following an episode of vaginal bleeding, if doctors would like to investigate it further, according to the Mayo Clinic.

What are the complications of placenta previa?

The main complications of placenta previa — which can have effects on both the baby and the person giving birth — are bleeding (which can be life-threatening and happen during labor, delivery, or within a few hours of birth) and preterm birth. As the Mayo Clinic explains, preterm birth might occur if severe bleeding prompts an emergency C-section before the baby is full term. Placenta previa does have the potential to be harmful to the baby if an early delivery — especially when it’s at a point before the fetus has fully developed (or close to fully developed) major organs, like lungs — is required.

How do you fix placenta previa?

Given that it’s not unusual for the placenta to shift at least somewhat throughout the pregnancy, in some cases, placenta previa resolves itself. When that doesn’t happen, the goal is to get as close to being full-term as possible, then delivering the baby via C-section when the time comes. According to MedlinePlus, some of the treatments and management options for placenta previa during pregnancy include:

  • Reducing your activities
  • Bed rest
  • Pelvic rest, which means no sex, no tampons, and no douching
  • Blood transfusions
  • Medicines to prevent early labor
  • Medicines to help pregnancy continue to at least 36 weeks
  • Shot of special medicine called Rhogam if your blood type is Rh-negative
  • Steroid shots to help the baby’s lungs mature

*In extreme cases of placenta previa, tocolytic medications, which help prevent preterm contractions and labor or blood transfusions, are used as forms of treatment. Cesarean deliveries are also the most recommended form of delivery for women with this condition. Usually, the delivery is planned after the 36th-week mark, but emergency cesareans can be performed if the patient is excessively bleeding.

What should you not do with placenta previa?

When dealing with placenta previa, it’s important to protect your body and stay away from certain activities.

  • Avoid vaginal intercourse after 28 weeks of pregnancy.
  • Do not use tampons, douches, or put anything into your vagina.
  • If you are spotting, use a pad and call your doctor immediately.
  • Don’t use over-the-counter drugs or herbs without notifying your doctor.
  • Avoid heavy lifting and avoid picking up items that are more than 20 pounds.
  • If you’re getting a pelvic exam, remind the physician or nurses that you have a placenta previa. 
  • Do not forget to call your doctor if you begin bleeding again. Always keep your phone close by.