During pregnancy, the placenta adheres to the walls of the uterus providing oxygen and nutrients to the fetus via the umbilical cord. In most cases it attaches to the upper or middle part of the uterus, but sometimes to the lower one. As a result, it obstructs the cervix, making natural childbirth difficult or impossible. However, this problem, known as placenta previa, does not prevent the expectant mother from giving birth to a healthy baby.
Steps
Part 1 of 3: Diagnosing Placenta Previa
Step 1. Follow up on antenatal care regularly
In most cases, placenta previa is diagnosed during a normal gynecological examination. Whether you suspect this condition or not, prenatal checks are one of the most important aspects of having a happy pregnancy. So go to your gynecologist or midwife regularly, without missing any appointments.
Having regular visits means seeing your gynecologist as soon as you think you are pregnant. You can then schedule other appointments as needed
Step 2. See your gynecologist if you notice vaginal bleeding
You should generally see it whenever you have bleeding, at any stage of your pregnancy, as it could indicate a miscarriage or other problems. If the bleeding occurs from the second trimester onwards, is characterized by clear discharge and is not accompanied by pain, it may be a symptom of placenta previa.
- The losses caused by placenta previa are both light and dark, and not necessarily continuous: they can stop and then start again.
- If the bleeding is heavy, you may want to go to the emergency room instead of waiting for the advice of the gynecologist.
Step 3. Request an ultrasound
To confirm the diagnosis of placenta previa, the gynecologist will do an ultrasound to see where the placenta is attached. In some cases, both abdominal and transvaginal ultrasound are performed. The latter is done by inserting a small transducer into the vagina.
Sometimes an MRI may also be necessary, but it is not an ordinary exam
Step 4. Get help if you have too early contractions
Like discharge, contractions before the ninth month should always be reported to the gynecologist. They can indicate premature birth or other gestational problems or be a symptom of placenta previa.
It is not easy to distinguish real contractions from Braxton-Hicks contractions, which all women experience during pregnancy. Don't be afraid and don't feel embarrassed to talk to your gynecologist if you want to dispel any doubts. In these circumstances, caution is never too much
Step 5. Request an accurate diagnosis
If your gynecologist diagnoses placenta previa, ask for more clarification. There are different types: the low placenta, the partial placenta previa, the total placenta previa.
- The low placenta means that it is attached to the lower part of the uterus, without covering the cervix. Often, this problem resolves spontaneously before delivery, as the placenta tends to rise during pregnancy.
- Partial placenta previa indicates that the placenta covers part of the cervix, but not all of it. Many of these cases resolve spontaneously before delivery.
- Total placenta previa completely covers the cervix, preventing natural childbirth. These cases are unlikely to resolve spontaneously before the baby is born.
Step 6. Learn about the risk factors
Several factors increase the risk of developing this condition. For example, if you are over the age of 30 or have never been pregnant, have a twin pregnancy or have uterine scarring, you are at greater risk of placenta previa.
It is important to quit smoking during pregnancy for a variety of reasons, but also because the chances of developing this disorder are increased
Part 2 of 3: Treating the Placenta Previa
Step 1. Go slow
To treat placenta previa, you need to slow down. In other words, avoid the most strenuous jobs. You will not be able to exercise or much of your normal daily activities.
You should also avoid traveling
Step 2. Ask your gynecologist for more clarification if he prescribes bed rest
If the bleeding is not excessive, your doctor will recommend that you stay in bed. The details may vary from case to case, but in general the forced rest is the same for all: you must lie down as much as possible, sitting or standing only if strictly necessary. However it can cause some health risks, such as deep vein thrombosis, so it is less recommended today than it used to be. If your gynecologist tells you to stay in bed, ask him for more clarification or seek the advice of another doctor.
Step 3. Follow the directions for pelvic rest
Pelvic rest implies the inability to perform activities that affect the vaginal area. For example, you can't have sex, use douches, or wear tampons.
Step 4. Check with the gynecologist the severity of your case
If you have low-lying placenta or partial placenta previa, the problem may go away on its own. Some women with these conditions find that the placenta has shifted at the time of delivery.
Step 5. Check for blood loss
The greatest risk to the pregnant woman's health is vaginal bleeding that usually accompanies placenta previa. In some cases, women with this problem can be affected by bleeding so severe that it becomes fatal. Whether you are at home or in the hospital, beware of heavy losses.
If the bleeding suddenly becomes heavy, go to the emergency room right away
Step 6. Consider how the other gynecological examinations will take place
In the case of placenta previa, the gynecologist will not spend too much time on vaginal checks, as it could aggravate the condition. He will also do an ultrasound to determine the position of the fetus and will certainly evaluate his heart rate more carefully.
Step 7. Be aware of the medications you are taking
While they will not cure your condition directly, your gynecologist may prescribe medications to prolong your pregnancy (to keep you from giving birth prematurely), as well as corticosteroids to allow the fetus's lungs to develop if you have to give birth early. In addition, he may prescribe blood transfusions following a heavy bleeding.
Part 3 of 3: Managing Placenta Previa
Step 1. Be prepared for the idea of going to the ER
Given the risk of serious complications, you could go to the hospital at any moment. If you start bleeding or your discharge suddenly becomes heavy, don't hesitate to go to the emergency room.
Step 2. Consider hospitalization
If the bleeding is severe, your doctor may recommend hospitalization. In this case you will be lying down most of the time and will have medical staff available in case of problems.
Step 3. Resort to Caesarean section if you have no other choice
If the leaks are uncontrollable or your health or that of the baby is at risk, the gynecologist will decide to undergo a caesarean delivery. It may also be necessary if the pregnancy has not yet come to an end.
- If the bleeding is not abundant, you could give birth naturally despite the placenta blocking the cervix. However, about 3/4 of women with this condition from the third trimester onwards are unable to sustain a natural birth. Doctors recommend pregnant women with placenta previa to prepare to give birth a few weeks in advance.
- If you previously had a caesarean delivery and now suffer from placenta previa, you are at greater risk of placenta accreta. This is a serious condition characterized by adherence of the placenta that prevents it from detaching after delivery. You will need to give birth in a hospital that is prepared to handle these kinds of emergencies, even with a large blood supply.
Step 4. Get informed
Look for information on placenta previa but also on caesarean delivery, as it can become an inevitable consequence of this disorder. Greater awareness of your problem will help you dissipate anxiety and feel more confident.
Step 5. Look for support
If you feel sad, depressed, frustrated, or anxious, confide in your partner, friend, or relative. It is normal to have low spirits when the pregnancy does not go as you expected and it is good to give vent to what you are feeling.
You could also join an Internet support group. There are several for people with placenta previa and bedridden. Consider joining one of these groups. Participants could offer you the understanding you need and help you tackle the problem with tips and strategies
Step 6. Make bed rest more enjoyable
If your gynecologist has prescribed forced rest - at home or in the hospital - try to make the most of the situation. Optimize the time you spend in bed: search and buy what your baby needs on the Internet, write thank you cards for those who send you gifts, do work tasks compatible with the doctor's recommendations. Don't forget, though, the things that calm you down, make you happy, or bore you less.
For example, you can watch your favorite movies or TV shows, read a good book, play computer or video games, talk on the phone or Skype with friends and family, challenge someone to a board or card game, keep a journal or write a blog
Step 7. Don't panic
Having placenta previa is definitely not ideal, and staying in bed can be very difficult. However, with proper care, you will give birth to a healthy baby, like most pregnant women who have this problem.
