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Patient education: Placenta previa (The Basics)

Patient education: Placenta previa (The Basics)

What is placenta previa? — Placenta previa is a condition that happens in pregnant people when the placenta covers the opening of the cervix. Normally, the placenta is not near the cervix (figure 1).

Placenta previa can cause severe bleeding from the vagina.

Placenta previa is more likely in people who:

Had more than 1 c-section – A c-section is a type of surgery used to deliver a baby. It is also called a "cesarean delivery."

Had placenta previa in a previous pregnancy

Other things that can make placenta previa more likely are:

Smoking

Giving birth several times before

Being pregnant with more than 1 baby at a time

What are the symptoms of placenta previa? — Most people leak blood from the vagina. In some, the uterus also tightens. Doctors call this "contractions." The belly can feel hard during contractions.

A few people do not have any symptoms of placenta previa.

Is there a test for placenta previa? — Yes. Your doctor or midwife can order a test called an "ultrasound." This is an imaging test that creates pictures of the baby inside your body. It also shows the placenta.

Should I see a doctor or nurse? — If you are pregnant and leaking blood from your vagina, call your doctor, nurse, or midwife right away.

How is placenta previa treated? — Your doctor, nurse, or midwife will tell you not to have sex. Sex can make the placenta previa bleed. Putting anything deep in the vagina can make the placenta previa bleed.

Treatment depends on your symptoms and how far along you are in your pregnancy. If placenta previa does not cause bleeding, you might have an ultrasound every few weeks to check it. The placenta sometimes moves into a normal position.

If you have a placenta previa that is bleeding, even a little bit, you will probably need treatment in the hospital right away. Your doctor or midwife will:

Check your heart rate and blood pressure – They will also check the baby's heart rate.

Check how much you are bleeding

Give you fluids through an "IV" – This is a thin tube that goes into a vein. The fluids help keep your blood flow and blood pressure as normal as possible.

If the bleeding is heavy and does not slow down, your doctor might:

Give you a blood transfusion – This is when you get blood that was donated by another person.

Deliver the baby with a c-section, even if it means the baby comes early

Most people who have placenta previa do not need to deliver the baby the first time they have bleeding. Some people might need to stay in the hospital until they give birth, but others can go home when the bleeding stops. While you are in the hospital, your doctor or midwife might give you:

Iron pills, if you lost a lot of blood

Steroid medicines – These help the baby's lungs get ready for birth, if it could be born early. These are not the same as the steroids some athletes take illegally.

A shot of "Rh immune globulin" if you are Rh-negative (which means your blood cells do not have a protein called "Rh factor")

If the placenta previa does not go away, your doctor will deliver the baby with a c-section about a month before your due date. This is because labor and vaginal delivery with placenta previa will cause severe bleeding. This is dangerous for you and your baby.

More on this topic

Patient education: C-section (cesarean delivery) (The Basics)
Patient education: What to expect in the NICU (The Basics)

Patient education: C-section (cesarean delivery) (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
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