Placenta Previa

WHAT YOU SHOULD KNOW:

• Placenta previa is a condition that can occur in your uterus (womb) before your baby is born. With placenta previa, your placenta grows near or over your cervix (opening out of your uterus). Your placenta is attached to the wall of your uterus. The placenta forms during pregnancy and brings oxygen and nutrition from the mother to the fetus (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. Bleeding often occurs in the late second or early third trimester of your pregnancy. You may also feel contractions (tightening and pain in your stomach). Your caregiver will ask you questions about your health and past pregnancies. He may also do a physical exam. Imaging tests, such as an ultrasound, may be done to check your unborn baby and placenta. Placenta previa may also resolve on its own before your baby is ready to be born. Treatment depends on how far along in your pregnancy you are. Treatment may include rest, medicines, and delivery (birth) of your baby.
  
  
• When you have placenta previa, you are at risk of having placenta accreta. Placenta accreta is when your placenta attaches deep into the wall of your uterus. Having placenta accreta with placenta previa puts you at a higher risk for bleeding. Ask your caregiver for more information about placenta accreta. Treatment may help decrease or resolve your bleeding. Treatment may also save yours and your baby's life.

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 when you have placenta previa may cause you to have fast heartbeats. You may be at risk for blood clots. Your placenta may pull away from your uterus when you have contractions. If your placenta pulls away, you and your baby may be in danger. With placenta previa, 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, and you may die.
  
  
• With placenta previa 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 function properly. If your baby is born too early, he may be very small, and he may die. After giving birth to your baby, you may need surgery to remove your uterus if you are bleeding uncontrollably. If you need surgery to deliver your baby, you may get an infection or bleed more than expected. Clots may form in your blood vessels, move to your lungs and cause trouble breathing. Talk your caregiver if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form 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:

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

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:

You may be given the following 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 germs called 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 where clots form inside your blood vessels.
  
  
• Rhesus immune globulin shot: A Rhesus immune globulin shot (RhIG) may be given before your baby is born. RhIG is needed if you and your baby have an Rh type mismatch. Rh mismatch 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 shots are given to prevent this from happening. Ask you caregiver for more information about RhIG shots.

Tests:

You may have any of the following:

• 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: An ultrasound uses sound waves to show pictures of your organs and tissue on a TV-like screen. It may show your placenta and your baby inside your uterus. You may have any of the following types of ultrasound done:
  
  
  • Transvaginal ultrasound: During a transvaginal ultrasound (TVS) a small tube is placed inside your vagina to look at your uterus. It may show if your placenta lies in the lower part of your uterus. A TVS may also show how close your placenta is to the edge or top of your cervix.
    
    
  • Abdominal ultrasound: During an 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.
  
  
• Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures of your pelvis are taken. The pictures may show where your placenta is in your uterus. An MRI may also show how if, and how deep your placenta has grown into your uterine wall. You will need to lie very still during an MRI. Never enter the MRI room with metal objects. This can cause serious injury.
  
  
• Amniocentesis: An amniocentesis test may be done between weeks 36 to 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 an amniocentesis.

Treatment options:

• Bed rest: You may need to be on bed rest until your baby is ready to be born. Bed rest may help to keep you and your baby out of danger. Talk to your caregiver about what activities are OK while you are on bed rest.
  
  
• 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: Early delivery of your baby may be needed when you have placenta previa. 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:

Pressure stockings are tight elastic stockings that put pressure on your legs. The pressure is strongest in the toes and decreases as it goes toward the thighs. The stockings help push blood back up to your heart and prevent clots from forming. Pressure stockings may be needed if you are on bed rest.

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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)