Placenta praevia
From ChildWiki.com
The placenta is an organ that is formed onto the internal uterine walls, short after conception. Through the placenta, the mother assures the fetus with oxygen and nutrients, and the fetus transmits towards the mother its various products. Usually, the placenta is attached above the cervix. In less than 1% of births, the placenta is formed at the base of the uterus, covering fully or partially the cervix. When the placenta blocks the cervix it is called placenta praevia.
[edit] Causes, Symptoms, Risks
The causes for placenta praevia are not known, but it is often associated with certain conditions, amongst which:
- Scars onto the uterine walls from previous pregnancies
- Fibrosis or other uterine anomalies
- The age of the pregnant woman (Above 35 is a risk factor)
- Smoking
- Placenta praevia in an anterior pregnancy
The higest risk in case of placenta praevia is bleeding. Usually, bleeding occurs as the inferior part of the uterus gets thinner, during the last trimester, while the labor preparing occurs.
This will determine the bleeding of that part of the placenta that is placed above the cervix.
Other risks involved:
- Abnormal implantation of the placenta
- Low fetal development
- Infection after birth
The most common symptoms of placenta praevia is vaginal bleeding. The blood is bright red and is it not associated with sensations or abdominal pains, especially during the thrid trimester.
Still, there are cases in which various symptoms can appear, but they can be common with other situations or medical problems.
[edit] Treatment of Placenta Praevia
A specific treatment will be advised by the doctor, with regards to the following aspects:
- The state and stage in which the pregnancy is
- The general health of the woman and her medical history
- The severity of the situation
- Tolerance to certain drugs
- Treatments of therapies
- Evaluation of the evolution of placenta praevia in this case
- Opinions and preferences of the patient
There is no treatment that can determine the placenta to change position.
Once placenta praevia is diagnosed, ultrasound examinations will be made more often to follow the localization of the placenta. An induced labor might be necessary, depending on the quantity of lost blood, the gestational age and the state of the fetus. In most placenta praevia cases, a cesarean is required. If bleeding is severe, transfusions might be also needed.
Because most cases with a placenta placed on the inferior walls are corrected until birth and there are no problems, no treatment will be given untilweek 20. After this period, without any other symptoms, the woman that has this diagnose has to modify her schedule and to increase the periods in which she rests in bed. In case of bleeding, hospitalization is mandatory to stabilize the situation.
Treatment that is normally recommended :
- Checking into the hospital and bed rest
- Monitoring the pregnancy carefully
- Iron and vitamin C supplements
- Blood transfusions when necessary to assure proper fetal development
A diet rich in fibers is recommended to avoid constipation. In many cases, if the woman has stopped bleeding for one week and she can get to the hospital fast, she can opt in for residence rest. The aim is to keep the pregnancy for at least 36 weeks.
At this moment, of the tests show the the fetus's lungs are matured enough, a cesarean will be made to reduce the risks of a massive and unexpected bleeding. If this bleeding appears before 36 weeks, the baby will be born prematurely through a cesarean, but most premature babies will survive due to advanced technology apparatus. 3 out of 4 women diagnosed with placenta praevia will deliver before labor starts through a cesarean.
99% of women that have placenta praevia will carry the pregnancy well, and the babies will survive without problems.
