Placenta previa

The Placenta previa occurs in about 0.5% of pregnancies. Medical measures are based on the severity of the symptoms.

What is placenta previa?

Placenta previa is a misalignment of the mother cake in pregnant women. The too low position of the placenta, which can partially or completely cover the cervix, manifests itself in the middle to last third of pregnancy as bleeding from the vagina.
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In the Placenta previa it is a misplacement of the placenta in the pregnant woman. Depending on the shape of a placenta previa, the birth canal is covered to varying degrees by the placenta.

In the context of the so-called placenta previa marginalis, the placenta makes contact with the inner cervix, but delivery via the vaginal route is usually possible. If, on the other hand, there is a placenta previa totalis, the inner cervix is ​​completely covered by the placenta; As a rule, a birth here has to be carried out using a caesarean section.

The main symptoms of placenta previa are vaginal bleeding that occurs towards the middle of pregnancy. This is mostly just maternal blood. The placenta previa occurs mainly in women who are multiparous and / or multiparous.

causes

The Placenta previa arises due to the implantation of a fertilized egg in the lower part of the uterus. Statistically speaking, the risk of placenta previa increases if a woman's uterus has been damaged in the past.

Corresponding damage can be the result of inflammation of the uterine lining or previous caesarean sections. Factors such as previous miscarriages, scraping of the uterus or so-called manual removal of the placenta also have a favorable effect on the development of placenta previa.

In medicine, manual placenta detachment is a necessary surgical removal of the placenta that does not detach itself from the uterus after the birth process has taken place. The exact causes of the implantation of a fertilized egg in the lower part of the uterus are still largely unknown.

Symptoms, ailments & signs

Placenta previa is a misalignment of the mother cake in pregnant women. The too low position of the placenta, which can partially or completely cover the cervix, manifests itself in the middle to last third of pregnancy as bleeding from the vagina. These can be interrupted, but they can also be continuous, usually light red blood from the mother.

If, in rare cases, the villi are also damaged, it can also be child's blood that leaks. The bleeding is usually not painful, but the pregnant woman can lose a lot of blood if the placenta completely covers the inner cervix, so that in some cases shock can occur. The blood loss often leads to circulatory problems and dizziness.

With placenta previa, the abdomen remains soft and is not sensitive to pressure. It often affects women who have already had several caesarean births or who have scraped off after miscarriages. Often bed rest is necessary in the presence of placenta previa, or in-patient admission to hospital in the case of severe bleeding. Most of the time, a caesarean section is necessary, as a natural birth carries the risk of excessive blood loss.

Diagnosis & course

Suspicion of a present Placenta previa occurs in various cases due to bleeding occurring during the last three months of pregnancy. Typically, such bleeding is painless.

Pregnancy examinations using ultrasound can also indicate the presence of placenta previa; the corresponding images allow a precise localization of the placenta. If a placenta previa is suspected, doctors urgently advise against carrying out a medical examination of the vagina (vagina) by palpation; this can increase bleeding.

As the placenta previa develops, the lower part of the uterus is stretched. These stretches are promoted by contractions of the uterus (the uterus). As a result of the uterine expansion, the placenta can now partially detach itself from the uterine lining and tear. As a result, the bleeding typical of placenta previa occurs. As a rule, medical measures are now required to ensure the integrity of mother and child.

Complications

With placenta previa, those affected usually suffer from various symptoms that can occur during pregnancy. This can be noticeable in heavy bleeding, but this does not have to be associated with pain. Also contractions do not occur and the patient's stomach feels very soft. In most cases, placenta previa is not associated with particular complications or other serious damage.

The child also develops normally in most cases, so that there are no complications here either. However, in many cases the placenta previa can lead to depression or other psychological complaints and possibly to anxiety in the patient. For this reason, a doctor must definitely be consulted with this disease.

The placenta previa is treated with the help of medication. This also usually does not lead to complications and the symptoms disappear relatively quickly. A caesarean section is only necessary in severe cases of placenta previa. Most of the time, however, there are no particular complaints.

When should you go to the doctor?

Placenta previa must always be treated by a doctor. If the disease is not treated, it usually leads to stillbirth and thus to further serious complications. Self-healing does not occur with this disease. A doctor should be consulted for placenta previa if irregular bleeding occurs during pregnancy. The severity of this bleeding can vary widely, with the blood usually being bright red.

Those affected also suffer from dizziness or circulatory problems, which can significantly reduce their quality of life. In most cases, the bleeding is not associated with pain. If these symptoms occur during pregnancy, a doctor must be consulted immediately. The placenta previa is treated by a gynecologist. In an emergency, the hospital should be visited; further treatment requires surgery. The mother's life expectancy is not negatively influenced by the placenta previa.

Treatment & Therapy

Proper treatment of the Placenta previa is based on various factors. For example, the severity of bleeding, the degree of maturation of the fetus and the general condition of the expectant mother play a role here.

In various cases, if there is placenta previa, inpatient care for the affected woman is medically sensible. If a placenta previa causes only slight bleeding in the patient and the child cannot yet be delivered due to its level of development, doctors often administer contraindicated medication.

In addition, depending on the individual case, active ingredients can be used that promote lung maturation in the fetus. In addition, doctors often recommend consistent physical restraint. Such restraint serves to avoid renewed bleeding.

If the placenta previa is accompanied by heavy bleeding and / or if the development of the child already allows delivery, this is often done as quickly as possible with the help of a caesarean section.

Outlook & forecast

The prognosis is as varied as the course of placenta previa. Both a deep-seated placenta and a placenta previa marginalis can go completely unnoticed, while a placenta previa totalis can sometimes even be associated with profuse bleeding and great danger to life.

In the case of placenta previa, possible bleeding usually stops spontaneously, so treatment is not necessary. However, it can also happen that bleeding becomes a mortal danger for the mother-to-be and the unborn child. In addition, bleeding that has already stopped may start to bleed again after a few days or weeks. With the right treatment and a conscious approach to the situation, it is still possible that patients with placenta previa give birth to healthy children. It makes no difference to the prognosis whether a spontaneous birth or a caesarean section is performed.

Basically, it must be said that the more placental tissue covers the cervix, the greater the likelihood of bleeding before or during childbirth. The risks themselves are generally very low. The maternal mortality is less than one percent, the fetal peripartum mortality (mortality rate before or during childbirth) around ten percent. If a placenta previa has already been diagnosed in an expectant mother, the risk of this disease recurring is up to eight percent.

prevention

Since the exact causes of an occurring Placenta previa are largely unclear, prevention is hardly possible. Regular check-ups during pregnancy can, however, help to identify any placenta previa at an early stage. Among other things, this enables measures to be taken that can reduce the risk of bleeding if the placenta previa is present (such as taking care of the expectant mother).

Aftercare

In most cases, those affected have only very limited follow-up measures available to placenta previa, so that a doctor should be consulted at an early stage. Only with a timely diagnosis can further complications be prevented, so that an ordinary pregnancy also proceeds. A doctor should therefore be consulted at the first signs and symptoms of placenta previa.

In most cases, people have to rely on various medications. It is always important to take the correct dosage regularly in order to relieve the symptoms permanently and correctly. If you have any questions or questions, you should always consult a doctor first.

Regular checks are also necessary during treatment in order to monitor the current state of the disease. In an emergency, a caesarean section must be performed. In many cases, the parents concerned are also dependent on psychological support from friends and relatives. This can prevent depression and other psychological upsets. The further course of the placenta previa depends very much on the severity of the disease, so that a general prediction is not possible.

You can do that yourself

A placenta previa can hardly be countered by self-help measures. The only diagnostic instrument for combating this is regular check-ups, which, however, fall within the medical field. Essential everyday tips can be summarized under the term "protection".

Affected women should not expose themselves to psychological pressure. In everyday life and at work it is important to take it easy. Stress regularly leads to the well-known symptoms of placenta previa. Observance of rest periods has proven to be particularly effective. A nap and a comfortable lying position on a sofa are sometimes the best means. Sports challenges are to be avoided in principle. Women should especially protect the area around the pelvis. This includes not having sex as well as not flushing the vagina. Tampons or other objects should never get into the vagina.

The partner and close friends and relatives should pay particular attention to harmony in everyday life when diagnosing placenta previa. By taking on tasks, you can help protect the mother-to-be. Last but not least, this also serves the well-being of the unborn child. Complications from psychological causes should not be underestimated.