In detail

Prior placenta

Prior placenta

Placenta is an organ that forms on the inner wall of the uterus shortly after conception. Through the placenta pass from mother to fetus oxygen and nutrients, and from fetus to mother different products of fetus.

The placenta is usually attached to the uterus above the cervix (lower part of the uterus or bladder). In less than 1% of births, the placenta forms at the base of the uterus and partially or completely covers the cervix. When the placenta blocks the cervix we are facing placenta previa.

Symptoms of placenta previa

- vaginal bleeding, sudden, painless, which may be in small or abundant quantity. The blood is usually bright red. Bleeding may occur as early as the 20th week of pregnancy, but is more common in the third trimester.

- symptoms of preterm birth. One in 5 pregnant women with placenta previa also have uterine contractions. Bleeding from the placenta previa may diminish or even stop for a while, but in almost all cases they will reappear in a few days or weeks.

Some pregnant women with placenta previa have no symptoms. In these cases, the placenta previa is ultrasound diagnosed, when an ultrasound will be performed for other causes, when the causes of vaginal bleeding will be investigated or if the bleeding begins at the onset of labor.

Bleeding can occur on several occasions during pregnancy. Although the bleeding itself is alarming, it may or may not be a serious complication. The period of time, the amount, the presence or absence of pain may vary depending on the cause. Bleeding in the first trimester of pregnancy is quite common and can be caused by:

- abortion (loss of pregnancy);
- Ectopic pregnancy (pregnancy in the fallopian tube);
- trophoblastic gestational disease (a rare disease that can be cancerous, in which fetal and placental tissues develop in the form of clusters);
- implantation of the placenta in the uterus;
- infections. Bleeding after the first 20 weeks can be caused by:
- the placenta previa (the placenta is close to or covers the cervix);
- detachment of the placenta (the placenta detaches prematurely from the uterus);
- other causes.

What is placenta previa?

The placenta previa is a situation where the placenta is attached to or near the cervix (opening of the uterus).

There are 3 types of placenta previa:

- total placenta previa - placenta totally covers the cervix;
- placenta previa partial - placenta partially covers the cervix;
- anterior margin placenta - the placenta is very close to the cervix.

What are the causes of placenta previa?

The causes of the previous placenta are not known, but it is associated with certain conditions, including:
- the presence, from previous pregnancies, of the scars on the uterine wall;
- fibroids or other abnormalities of the uterus;
- previous operations on uterus or caesarean section
- age of pregnancy (over 35 years);
- smoking;
- previous placenta in a previous pregnancy.

Why is placenta a problem?

The greatest risk in the case of the placenta previa is bleeding (bleeding). Usually the bleeding occurs as the lower part of the uterus becomes thinner, during the third trimester of pregnancy - preparation for labor.

This causes the bleeding of that part of the placenta above the cervix.

The larger the part of the placenta that covers the cervix, the greater the risk of bleeding.

Other risks:

- abnormal implantation of the placenta;
- low fetal development;
- premature birth;
- birth defects;
- infection after birth.

What are the symptoms of the placenta previa?

The most common symptom of the placenta previa is vaginal bleeding, bright red and not associated with sensations or abdominal pain, especially in the third trimester of pregnancy.

However, there are cases where different symptoms may occur or they may be common to other medical situations or problems.

Always consult your doctor for diagnosis.

How is placenta previously diagnosed?

In addition to a complete medical history and medical examination, ultrasound examination can be used to diagnose the placenta previa. Ultrasound examination can show the location of the placenta as well as the size of the area that covers the cervix.

More accurate results will be provided by a vaginal ultrasound examination.

Although an ultrasound examination may show a low placenta in early pregnancy, there are few women who will develop it in the placenta previa. It is normal for the placenta to rise and move away from the cervix as the uterus grows (placental migration).

Treatment of the placenta previa

A specific treatment will be established by the doctor, taking into account the following:

- the state and the stage in which the task is;
- general health status and medical history;
- The gravity of the situation;
- tolerance to different drugs;
- treatments or therapies;
- evaluation of the evolution of the situation;
- the patient's opinions and preferences.

There is no treatment to cause the placenta to change. Once the placenta previa is diagnosed, ultrasound examinations will be performed more often to track the placenta location.

A birth challenge may be necessary, depending on the amount of blood lost, the gestational age and the condition of the fetus.

In most cases of placenta previa the caesarean section is required. In case of severe bleeding, blood transfusions may be required.

Because most cases with placenta at the lower level are corrected until birth and no problems occur, no treatment is applied until week 20.
After this period, without any other symptoms, the woman diagnosed with Placenta Previa must change her work schedule and increase the rest period in bed.
In case of bleeding, hospitalization is mandatory for stabilizing the situation.
Treatment is normally recommended. It includes:
hospitalization and rest in bed (plus personal bathroom), careful monitoring of pregnancy, supplementation with iron and vitamin C, blood transfusion when necessary to ensure maturation of the fetus until birth.
A diet high in fiber is recommended (to eliminate constipation and prolonged skimming).
Often, in the case of a woman who does not bleed for a week and her access to the hospital is easy (maximum 15 minutes), one can opt for permanent supervision at home and strictly follow the treatment.
The goal is to keep the pregnancy for at least 36 weeks.
At this time, if the tests show that the lungs of the fetus are well developed, Caesarean section will be done to reduce the risk of massive and unexpected bleeding.
However, if this bleeding occurs before the age of 36 weeks, Caesarean section is also chosen (premature baby), but due to the intensive care medical equipment, most children are much better connected to this equipment than to the placenta in the womb.
3 women out of 4, with Placenta Previa, give birth by Caesarean section before starting the birth pains. If this problem is not discovered until the birth starts, the bleeding is easy and the placenta does not block the cervix, then natural birth can be tried.

In any case the results are generally good: 99% of women with Placenta Previa go through this task well, as do their children.

Detachment of placenta

General characterization

What is placenta detachment?

Detachment of the placenta represents the premature separation of the placenta from the uterine wall. The placenta contains many blood vessels that allow the transfer of nutrients from the mother to the fetus.

If the placenta starts to separate during pregnancy, these vessels will bleed. The larger the detached area, the greater the amount of blood. Detachment of the placenta occurs approximately in a case of 120. It is also called the placenta abruptio.

What Causes Placental Detachment?

Apart from the direct trauma of the uterus, such as car accidents, the causes of placenta detachment are not known.

However, placenta detachment is associated with certain conditions such as:

- a previous pregnancy with placenta detachment;
- hypertension (high blood pressure);
- smoking;
- multiple pregnancy.

Why is placenta detachment a problem?

Detachment of the placenta is dangerous due to the increased risk of bleeding.

Although severe placental detachment is rare, other complications may occur such as:

- bleeding and shock;
- disseminated vascular coagulation (eng: DIC - disseminated vascular coagulation) - a serious complication related to blood coagulation;
- low blood flow and kidney and brain disorders
postpartum hemorrhage.

Symptoms and treatment of placental abruption

What are the symptoms of placenta detachment?

The most common symptom of placental detachment is vaginal bleeding of a dark red, accompanied by pain, in the third trimester of pregnancy.

It may also occur during labor.

However, the symptoms differ from woman to woman.

Symptoms may be:

- vaginal bleeding;
- abdominal pain;
- uterine contractions that do not weaken in intensity;
- the presence of blood in the amniotic fluid;
- nausea;
- thirsty;
- sensation of fainting;
- low fetal movements.

The symptoms of placenta detachment may resemble those of other medical conditions.

Always consult your doctor for diagnosis.

How is placental detachment diagnosed?

The diagnosis of placental detachment is usually based on the symptoms presented, the amount of bleeding and the intensity of the pain.

Ultrasound examination can also be used to locate the bleeding and check the fetus.

There are 3 levels of placental detachment:

Level 1 - small amount of blood and some uterine pain; there are no signs of discomfort of the fetus, the mother does not have hypotension.

Level 2 - moderate amount of blood, uterine contractions, measurement of fetal pulse may show signs of discomfort.

Level 3 - severe blood or hidden bleeding, uterine contractions that do not weaken in intensity, abdominal pain, hypotension, death of the fetus.

Sometimes, the placental detachment is diagnosed only after birth, when blood clots are found underneath the placenta.

Treatment of placental detachment:

A specific treatment will be established by the doctor, taking into account the following:

- the state and the stage in which the task is;
- general health status and medical history;
- The gravity of the situation;
- tolerance to different drugs;
- treatments or therapies;
- evaluation of the evolution of the situation;
- the patient's opinions and preferences.

There is no treatment for stopping the placenta or detaching the uterine wall. From the moment the placenta is diagnosed, the care depends on the amount of blood lost, the gestational age and the condition of the fetus. In most cases of placenta detachment the caesarean section is performed.

An emergency birth may be necessary. In case of severe bleeding, blood transfusions may be required.

Tags Placenta previa Placenta task