Placenta Previa

WHAT YOU SHOULD KNOW:

Placenta previa is a condition in which your placenta grows near or over your cervix (opening of your uterus). The placenta forms during pregnancy and provides oxygen and nutrition to your unborn baby. The placenta also removes waste products from the fetus. Normally, your placenta grows in the upper part of your uterus. When your placenta grows near your cervix, it may block the opening to your vagina. You may have vaginal bleeding that could harm you and your unborn baby.

Normal placental attachment Placenta previa (complete)

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Medicines used to treat placenta previa may cause you to have a fast heartbeat. You may be at risk for blood clots. Your placenta may pull away from your uterus when you have contractions. You may have sudden, large amounts of bleeding. You may need a blood transfusion to replace the blood you have lost. Large amounts of blood loss may be life-threatening. Placenta previa increases your risk of placenta accreta. Placenta accreta is when your placenta attaches deep into the wall of your uterus. The deep attachment makes it hard for your placenta to come out after your baby is born. Placenta accreta increases your risk for bleeding even further.

  • Your baby may not grow as he should inside your uterus. He may be forced into an abnormal birthing position. Your unborn baby may also have problems with his heartbeat. Your baby may be born too early and his lungs may not be fully developed. He may also be very small. This could be life-threatening for your baby. If you need surgery to deliver your baby, you may get an infection or bleed more than expected. After you give birth, you may need surgery to remove your uterus if you have bleeding that cannot be stopped. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV fluids:

You may be given fluids through an IV if you have lost a large amount of blood. Fluids may be given to keep your blood pressure normal. An IV is a tube placed into your vein.

Fetal monitor:

Caregivers may use a fetal monitor to check your baby's heartbeat. You may need to keep the monitor on at all times. You may also only need to wear the monitor when your caregiver feels it is needed.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

  • Tocolytics: Tocolytics are given to stop contractions if your baby is not ready to be born. Contractions are when the muscles of your uterus tighten and loosen.

  • Steroids: Steroids may be given if you need to deliver your baby earlier than expected. These medicines help your baby's lungs to mature and prevent breathing problems after he is born.

  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by bacteria. Antibiotics may be needed if you have an infection in your uterus.

  • Blood thinners: Blood thinners prevent clots from forming in your blood. They may be given if you are at risk for deep vein thrombosis (DVT). DVT is a condition in which clots form inside your blood vessels.

  • Rh immune globulin shot: You may be given an Rh immune globulin injection (RhIG) before your baby is born. RhIG is needed if you and your baby have different Rh blood types (incompatibility). Rh incompatibility means that your baby has a protein in his blood that you do not. Your body may make antibodies against your baby's blood and destroy his blood cells. RhIG injections prevent this from happening.

Tests:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Ultrasound:

    • Transvaginal ultrasound: Caregivers place a small tube inside your vagina to see if your placenta lies in the lower part of your uterus. It may also show how close your placenta is to the edge or top of your cervix.

    • Abdominal ultrasound: A small device will be moved around your abdomen to show pictures of your uterus. Your caregiver may want you to have a full bladder for this test. It may show if your placenta is blocking the opening of your uterus. It may also show problems with your baby, such as slow growth.

    • Doppler ultrasound: A Doppler ultrasound may be done to check if your placenta has grown into the wall of your uterus.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your pelvis. MRI pictures may show where your placenta is in your uterus. An MRI may also show if and how deep your placenta has grown into your uterine wall. You may be given dye to help the placenta show up better in the pictures. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with any metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

  • Amniocentesis: An amniocentesis test may be done between weeks 36 and 37 of your pregnancy if you are not bleeding. This test is done to check your unborn baby's lungs if you have a C-section date planned. Ask your caregiver for more information about amniocentesis.

Treatment:

  • Bedrest: You may need to be on bedrest until your baby is ready to be born. Ask your caregiver which activities you may do while you are on bedrest.

  • Blood transfusion: You may need a blood transfusion if you lose a large amount of blood. During a blood transfusion, you will get donated blood through your IV. You may need a transfusion while you are still pregnant or after your baby is born.

  • Delivery of your baby: Your baby may need to be delivered early. If your due date is close, and your placenta does not cover your cervix, you may be able to give birth vaginally. If your placenta covers most or all of your cervix, a C-section will be done. A C-section may also be done if you have heavy bleeding or you or your baby is in danger.

Pressure stockings:

These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. Pressure stockings may be needed if you are on bedrest.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Placenta Previa (Inpatient Care)

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