Placenta Previa

The placenta is the baby’s lifeline during pregnancy, it’s an organ which grows in the womb and is connected to the baby via the umbilical cord; it provides baby with Oxygen and nutrients which pass from your blood supply into the placenta and are then carried to your baby via the umbilical cord; carbon dioxide and other waste products are also carried away from the baby by the umbilical cord to the placenta and then into your bloodstream for disposal. Hormones produced by the placenta help your baby grow and develop; It offers your baby protection against bacterial infections while in the womb, and towards the end of pregnancy it passes antibodies from you to your baby which should give him or her immunity for about three months after birth. However, it only passes on antibodies that you already have. In most pregnancies, the placenta attaches at the top or side of the uterus. Placenta previa occurs when a baby’s placenta partially or totally covers the mother’s cervix, which can cause severe bleeding during pregnancy and delivery.

If you have placenta previa, then you may bleed throughout pregnancy and during delivery; and your doctor will probably recommend that you avoid certain activities, such as, having sex and running. If the placenta previa is diagnosed early in pregnancy then there is a chance that the placenta will move as the uterus grows, however, If the placenta doesn’t move then you will need a caesarean section. You should call your doctor if you have vaginal bleeding during the second or third trimester, and if the bleeding is severe then you should seek emergency care.

Diagnosis

An ultrasound scan will be used to diagnose placenta previa, and you will probably need extra ultrasounds throughout your pregnancy to check the position of the placenta.

Treatment

There is no medical treatment for placenta previa, however there are ways to manage the bleeding; the recommendations will depend on various factors:

For little or no bleeding

  • Pelvic Rest – avoiding activities that can trigger bleeding, such as sex and exercise.
  • Seek emergency care if bleeding starts.
  • If the placenta is low lying but doesn’t cover the cervix, you might be able to have a vaginal delivery. Your health care provider will discuss this option with you.

For heavy bleeding

  • Seek immediate emergency help, Some women with severe bleeding may require a blood transfusion.
  • A Caesarean will be planned for as soon as the baby can be delivered safely (ideally after 36 weeks of pregnancy)
  • If bleeding persists you may need an earlier delivery and you will be offered steroids to mature your baby’s lungs.

For bleeding that won’t stop

  • If your bleeding can’t be controlled or your baby is in distress, you’ll need an emergency C-section — even if the baby is premature

Risk Factors

Although the cause of placenta previa is largely unknown, there are certain things that have been found to increase the risk. These are:

  • Have had a baby before
  • Have scars on the uterus from previous surgery (caesarean deliveries, uterine fibroid removal, and dilation and curettage)
  • Had placenta previa with a previous pregnancy
  • Multiple pregnancy
  • Are age 35 or older
  • Smoking

Complications

You will be monitored to reduce the risk of serious complications such as:

  • Severe bleeding (haemorrhage) which can occur during labour, delivery or in the first few hours after birth.
  • Severe bleeding may prompt an emergency C-section before your baby is full term.

Have you experienced placenta previa? What was the outcome? What support did your care provider offer you?

Placental Abruption

Overview

The placenta is the baby’s lifeline during pregnancy, it’s an organ which grows in the womb and is connected to the baby via the umbilical cord; it provides baby with Oxygen and nutrients which pass from your blood supply into the placenta and are then carried to your baby via the umbilical cord; carbon dioxide and other waste products are also carried away from the baby by the umbilical cord to the placenta and then into your bloodstream for disposal. Hormones produced by the placenta help your baby grow and develop; It offers your baby protection against bacterial infections while in the womb, and towards the end of pregnancy it passes antibodies from you to your baby which should give him or her immunity for about three months after birth. However, it only passes on antibodies that you already have.

In 2013 the NCBI (National Center for Biotechnology Information) published a study which found that placental abruption affects 0.7% – 1% of pregnancies; however, according to Tommy’s it is suspected that this figure may be higher as abruption isn’t always diagnosed. This is a serious condition in which the placenta begins to detach from the uterus, meaning that the baby can become starved of oxygen and nutrients.

Causes and Risk Factors

Very often the cause of abruption is unknown; however, there are factors that can increase the risk. These are:

  • Abdominal trauma – maybe from a fall or a car accident
  • Previous placental abruption
  • High blood pressure
  • Smoking
  • If your waters have broken prematurely
  • Blood-clotting disorders
  • Multiple pregnancy – the delivery of the first baby can cause changes in the uterus that trigger placental abruption before the other baby or babies are delivered.
  • Maternal age – women over 40
  • Using drugs (especially cocaine) in pregnancy
  • Previous caesarean birth
  • History of recurrent miscarriages

Symptoms

Placental abruption occurs most frequently in the last trimester of pregnancy (especially in the last few weeks) and symptoms include:

  • Vaginal bleeding
  • Abdominal pain
  • Back pain
  • Uterine tenderness
  • Rapid uterine contractions, often coming one right after another

Abdominal pain and back pain often begin suddenly and the amount of bleeding can vary. If the blood becomes trapped inside the uterus by the placenta it is also possible to have a severe placental abruption with no visible bleeding. In some cases, placental abruption develops slowly. If this happens, you might notice light, intermittent vaginal bleeding. Your baby might not grow as quickly as expected, and you might have low amniotic fluid (oligohydramnios) or other complications

If you notice any of the symptoms then please get medical help immediately because they may signify an emergency.

Treatment

The treatment for placental abruption will depend on the severity and gestation. Women under 34 weeks with a minor placental abruption are usually monitored closely in hospital, your care provider will ensure that baby is growing correctly, and will also look for any signs of preterm labour. If there is a risk of your baby not growing properly then labour may be induced. If the abruption is more severe, you are losing lots of blood and the baby is in distress or at risk of not growing properly you may need to have your labour induced or have an emergency caesarean.

Complications

Placental abruption can cause life-threatening problems for both mother and baby.

Mother

  • Shock due to blood loss
  • Blood clotting problems (disseminated intravascular coagulation)
  • The need for a blood transfusion
  • Failure of the kidneys or other organs
  • Hysterectomy

Baby

  • Oxygen and nutrient deprivation
  • IUGR
  • Premature birth
  • Stillbirth

The study showed that:

19% of cases were stillborn, 11% of new born baby’s had an apgar score under 7 at 5 minutes, 34% of newborn baby’s had weight less than 2500g (2.5kg or 5lb 8oz) and 40% of newborn babies were admitted to NICU.

Have you suffered with placental abruption? Please feel free to share your story