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Placenta Previa is potentially serious medical condition when there is an unexpected change of placement of the Placenta during Pregnancy.

Under normal conditions the placenta is attached to the Uterine Wall

With placenta previa, the placenta shifts downward and approaches the Cervix and often covers it. This is typically seen during the third trimester but can occasionally occur during the first or second trimesters as well..

It is one of the major reason for vaginal bleeding during pregnancy.

It can occur in nearly 0.5% of all pregnancies.

Symptoms are most often bleeding and a low blood pressure. But other symptoms may be seen. It is important to note that abdominal pain is not often seen.

If there is a lot of abdominal pain with bleeding – other medical conditions may be seen. This includes but is not limited to Placenta Abruption.

Treatment may include bed rest for those with a minimal discomfort or problem. Often the avoidance of sexual activity is recommended.  Meeting with and following your doctor’s recommendations is important.

Most Common Symptoms:

–  Vaginal bleeding – often bright red
–  Often there is no pain involved
–  Abdomen is often soft

Classifications:

1.)  Type I  –  low lying  – Approaches the lower uterus, not affecting the cervical os
2.)  Type II  –  marginal  –  Touch the top of cervix
3.)  Type III –  partial  –  Partially covers top of cervix
4.)  Type IV  –  complete –  Entire top of cervix is covered

Risk Factors

–  A previous placenta previa
–  A previous abortion
–  A previous C-section delivery
–  Large placenta
–  Smoking
–  Age – below 20 and above 30

Diagnosis

–  Ultrasound is very important in diagnosis of this condition
–  Physical Exam
–  Blood work may be beneficial

Treatment:

–  Initially (20 years ago) treatment was provided solely inside hospitals once the diagnosis was made
–  Today, more treatment is allowed on an outpatient basis, as long as mother and child are not in any distress.
–  Also if fetus is less than 30 weeks

If distress is present:

1.)  Immediate delivery may be the only option.
2.)  Vaginal delivery is an option in some cases but many are delivered by C-section.
3.)  The concerning factor for vaginal delivery is continued separation of the placenta and the uterus
4.)  This will increase bleeding and it becomes more dangerous for the mother.