Pregnancy: Placenta Previa (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Placenta previa facts
- What is placenta previa?
- What are the types of placenta previa?
- Who is at risk for placenta previa?
- What causes placenta previa?
- What are the symptoms of placenta previa?
- How is placenta previa diagnosed?
- What is the treatment for placenta previa?
- What are possible complications of placenta previa?
- Can placenta previa be prevented?
- What is the prognosis (outlook) for placenta previa?
- Find a local Obstetrician-Gynecologist in your town
What are the symptoms of placenta previa?
Bleeding is the primary symptom of placenta previa and occurs in the majority (70%-80%) of women with this condition. Vaginal bleeding after the 20th week of gestation is characteristic of placenta previa. Usually the bleeding is painless, but it can be associated with uterine contractions and abdominal pain. Bleeding may range in severity from light to severe.
How is placenta previa diagnosed?
An ultrasound examination is used to establish the diagnosis of placenta previa. Either a transabdominal (using a probe on the abdominal wall) or transvaginal (with a probe inserted inside the vagina but away from the cervical opening) ultrasound evaluation may be performed, depending upon the location of the placenta. Sometimes both types of ultrasound examination are necessary.
It is important that the ultrasound examination be performed before a physical examination of the pelvis in women with suspected placenta previa, since the pelvic physical examination may lead to further bleeding.
What is the treatment for placenta previa?
Treatment of placenta previa depends upon the extent and severity of bleeding, the gestational age and condition of the fetus, the position of the placenta and fetus, and whether the bleeding has stopped.
Cesarean delivery (C-section) is required for complete placenta previa and may be necessary for other types of placenta previa. A Cesarean delivery is usually planned for women with placenta previa as soon as the baby can be safely delivered (typically after 36 weeks' gestation), although an emergency Cesarean delivery at any earlier gestational age may be necessary for heavy bleeding that cannot be stopped after treatment in the hospital (see below).
Women who are actively bleeding or who have bleeding that cannot be stopped will be admitted to the hospital for further care. If there has been little or no bleeding or the bleeding has stopped, bed rest at home may be prescribed. Home care is not always appropriate, and women who remain at home must be able to access medical care immediately should bleeding resume. Women with placenta previa in the 3rd trimester of pregnancy are advised to avoid sexual intercourse and exercise and to reduce their activity level.
Women with placenta previa who experience heavy bleeding may require blood transfusions and intravenous fluids. In some cases, tocolytic drugs (medications that slow down or inhibit labor), such as magnesium sulfate orterbutaline (Brethine) are necessary. Corticosteroids may be given to enhance lung development in the fetus prior to Cesarean delivery.
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