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Placenta Previa - What it is, What it Means

Placenta previa - a condition in which the placenta is attached in the lower half of the uterus and may touch or cover the cervix - used to pose a serious threat to both mother and baby. New treatments and the ability to make an earlier diagnosis now mean that the odds are greatly in favor of a successful birth for both mother and child.

Before the twentieth week of pregnancy, a low-lying placenta is not uncommon. Nor is it cause for worry. Placentas often migrate upward as the lower part of the uterus stretches and grows. In 1% (or less) if full-term pregnancies, the placenta will not migrate, leading to a diagnosis of placenta previa.

The most common sign of placenta previa is sudden, painless vaginal bleeding, caused when the placenta pulls away from the lower part of the stretching uterus. This bleeding is most common in the last trimester, and is often bright red. It may taper off and even stop, but it usually starts again within a few days or weeks.

Some women with placenta previa will have no symptoms. The condition may be discovered during a routine ultrasound or may not be discovered until delivery. An ultrasound exam is also used to make a diagnosis of placenta previa. Pelvic exams are not used to make a diagnosis unless an immediate cesarean section is planned, because the exam could cause further injury to the placenta.

If you've been diagnosed with placenta previa, you can expect mild to strict restrictions on your activity. Increasing bed rest after the 20th week is typical. If you are bleeding, especially if it is frequent or severe, you will probably be hospitalized so you and your baby can be carefully monitored. Blood loss may mean that you need a transfusion or nutritional therapy, such as increased iron.

The goal of this treatment is to try to keep the pregnancy going until at least 36 weeks or when the baby's lungs have matured and he or she has the strongest chance of being born healthy. Delivery will probably be through cesarean section to help avoid the risk of serious bleeding. If bleeding during the pregnancy becomes severe to the point of endangering you or your baby, the baby will be delivered immediately by cesarean.

Careful monitoring and swift, safe delivery have made placenta previa far safer for both mother and baby than ever before.

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