Placenta Previa

GENERAL INFORMATION:

What is it?

• Placenta (pluh-SEN-tuh) previa (PREE-v-uh) means "placenta first." The placenta is an organ that grows inside you with your baby. The placenta joins you to your baby, and is also attached to the inside wall of your uterus (womb). It usually comes out right after your baby is born. The placenta is also called "afterbirth." It brings food to your baby and takes away waste when you are pregnant.
  
  
• Placenta previa is when the placenta grows and covers the cervix (opening out of your uterus). The vagina (birth canal) may be partly or totally blocked by the placenta. With placenta previa, the placenta is stretched and pulled from where it is attached to the uterus. This causes bleeding and can harm your baby.

Causes: It is not known what causes placenta previa. The following are reasons why you may be more likely to have placenta previa:

• If you have had more than one pregnancy.
  
  
• If you have scar tissue in the uterus from surgery.
  
  
• If you had a cesarean section for a past birth.
  
  
• If you have had one or more abortions.
  
  
• If you are over age 35.
  
  
• If you smoke cigarettes.
  
  
• If you use illegal drugs like crack and cocaine.

Signs and Symptoms: You may have sudden vaginal bleeding, but no pain. You may also feel contractions (tightening and pain in your stomach). If the placenta is totally blocking your vagina, you may bleed early in your pregnancy. The most common time to bleed with placenta previa is in the 29th and 30th weeks. But, you may bleed at any time during your pregnancy. You may bleed in little amounts or bleed a large amount of blood at one time.

Tests:

• Ultrasound looks for problems with your baby, such as slow growth. It also looks for problems with the placenta, like unexpected growths or being in the wrong place. Ultrasounds can tell the gestational (jes-TA-shun-ull) age of your baby. The gestational age is the amount of time the baby has been growing inside you. There are two ways an ultrasound for placenta previa can be done.
  
  
  • Abdominal (Fetal) Ultrasound: This test uses sound waves to show pictures of your baby (fetus) inside your uterus (womb). These pictures are seen on a TV-like screen. Your caregiver may want you to drink fluids before this test.
    
    
  • Transvaginal Ultrasound: This test uses sound waves to show pictures of the inside of your uterus (womb). For this type of ultrasound, a small tube is placed into your vagina. Pictures of your uterus are taken and seen on a TV-like screen.
  
  

Treatment: Your treatment may depend on the gestational age of the baby. It can also depend on how much of your vagina opening is covered by the placenta. You may need to be put in the hospital for tests and treatments.

• Bedrest: You may have to stay in the hospital, or you may be allowed to go home. Your caregiver may put you on bedrest. This means you may only be allowed out of bed to go to the bathroom. You may have to take special medicines so that you do not have your baby too early.
  
  
• Blood Transfusions: If you bleed a lot, you may need to get a blood transfusion (trans-FEW-shun). You might need a transfusion during pregnancy or when your baby is born.
  
  
• Cervical Cerclage (SER-klaz): Your caregiver may want you to have a procedure called cervical cerclage. This is when a stitch is placed around your cervix. The stitch may help hold in the placenta so you will not have your baby too early.
  
  
• Cesarean (suh-SAIR-e-in) Section: With placenta previa, your baby may have to be born early. Your delivery might have to be by cesarean section. A cesarean section is done when you cannot have your baby through your vagina. Your caregiver makes an incision (cut) in your lower abdomen (belly) and into the uterus. The baby is delivered through this incision.

Support:

• Accepting that you have placenta previa is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a woman with placenta previa.
  
  
• You may be worried about your health and the health of your baby. It may help if you stay aware of the baby moving inside you. Your caregiver may want you to keep track of how much your baby moves. You may also listen to the baby's heart beating with a doppler or through a stethoscope (STETH-uh-skop). You may listen to the baby's heart beating with your caregiver. Ask your caregiver about listening to the baby's heartbeat.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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