This video shows Placenta Previa with a gestational age of the fetus about 19 weeks and three days.
Due to placental trophotropism, the diagnosis of a placenta previa is not usually made before 20 weeks. During the 'routine' 18 to 21-week morphology scan, the distance between the lower edge of the placenta and the internal os should be measured.
Placenta previa is diagnosed through ultrasound, either during a routine prenatal appointment or after an episode of vaginal bleeding. Most cases of placenta previa are diagnosed during a second-trimester ultrasound exam.
If there is placenta previa, when the cervix begins to efface (thin out) and dilate (open up) for labor, blood vessels connecting the placenta to the uterus may tear. This can cause severe bleeding during labor and birth, putting mother and baby in danger.
Placenta previa treatment goals are to prevent bleeding and lessen the risk of premature delivery. More than 90 percent of the time, placenta previa diagnosed in the second trimester corrects itself by term. You don't need to restrict your activities or undergo any treatment.
Placenta praevia occurs in four grades, ranging from minor to major: Grade 1 – (minor) the placenta is mainly in the upper part of the womb, but some extend to the lower part. Grade 2 – (marginal) the placenta reaches the cervix but doesn't cover it. Grade 3 – (major) the placenta partially covers the cervix.
Placenta moving up?
This often shows up in early ultrasound scans when it is called the low-lying placenta. In 90% of cases, the placenta moves upwards as the womb grows. For some women, however, the placenta continues to lie in the lower part of the uterus after 20 weeks. This affects 1 in 200 births.
For cases of placenta previa with minimal or no bleeding, your doctor will likely suggest bed rest. This means resting in bed as much as possible, and only standing and sitting when absolutely necessary. You'll also be asked to avoid sex and likely exercise as well.
Vaginal bleeding after the 20th week of gestation is characteristic of placenta previa. Usually, the bleeding is painless, but it can be associated with uterine contractions and abdominal pain. Bleeding may range in severity from slight to severe.
ACUTE CARE OF BLEEDING PLACENTA PREVIA An actively bleeding placenta previa is a potential obstetric emergency. These women should be admitted to the Labor and Delivery Unit for maternal and fetal monitoring, and the anesthesia team should be notified.
Placenta previa occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery.
A recent study looked at nearly 1500 cases of low-lying placenta diagnosed in the second trimester and found that over 98% had resolved before delivery. Most (84%) had cleared before 32 weeks. The rare cases that didn't resolve (the extra 1.6%) delivered their babies via c-section with no further complication.
If placenta previa demands early delivery of a premature baby, the baby can experience several negative effects including low birth rate and breathing problems that may cause brain damage and cerebral palsy.
Only one in 10 women who have a low-lying placenta will develop placenta praevia.
Since ultrasound isn't 100 percent reliable, and not everyone opts for early screening tests, you might use the position of your placenta to predict what you're having. According to some, having an anterior placenta means you're having a girl, whereas a posterior placenta means you're having a boy. If the placenta is on the right side, then you are believed to be having a boy. But if the placenta is on the left then there is a high likelihood that the child will be a girl.
The lining of the uterus (endometrium) has abnormalities such as fibroids or scarring (from previous previa, incisions, cesarean sections, or abortions). The placenta formed abnormally. The pregnancy is multiple (i.e., twins or triplets).
Some of the complications of placenta previa include:
Major hemorrhage (bleeding) for the mother.
The shock from loss of blood.
Fetal distress from lack of oxygen.
Premature labor or delivery.
Health risks to the baby, if born prematurely.
Emergency cesarean delivery.
