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7 causes of placenta previa and how to treat this complication

Placenta previa or low placenta, as it is also called, is a complication during pregnancy that can pose risks to the baby and the mother. To talk about it, gynecologist and obstetrician Dr. Rogério Tabet (CRM:97801), from the Public Health System, explained what it is, cited the most common causes and indicated the treatments. Check out!

What is placenta previa?

According to the obstetrician, placenta previa is the intrauterine low insertion placenta, that is, when the placenta is fully or partially inserted into the lower part of the uterus. Usually, this complication is identified in the second trimester of pregnancy and usually happens due to “the incidence of uterine abnormalities and malformations”, he added. In addition, other causes may also be related as described below:

7 most common causes of placenta previa

  • Many previous pregnancies;
  • twin pregnancy;
  • Invasive and intrauterine processes;
  • Uterine surgical procedures such as myomectomy;
  • Post-abortion curettage;
  • Previous cesareans;
  • Anterior placenta previa.

You already know the main causes, however, there are some types of placenta previa. Find out more below!

The most common types of placenta previa

The obstetrician reported that there are three most common types of placenta previa, classified according to their location in the uterus, they are:

marginal placenta previa

According with the doctor. Rogério, the marginal or lateral placenta previa touches the internal os of the uterine cervix. “The internal orifice is where direct contact is made with the baby, and the external orifice is used for vaginal examination or pap smears, for example”.

partial placenta previa

As the obstetrician explained, “partial placenta previa is one that does not fully cover the internal cervical os.” In this case, when the pregnant woman goes into labor, it is up to an obstetric evaluation with the patient to verify the best way of delivery.

Placenta previa total center

As for the total center placenta previa, the doctor said it was “the one that completely covers the cervix”. In this case, it is a more serious condition, the woman cannot go into labor and no type of vaginal examination can be performed. “Under no circumstances can vaginal examination be performed due to the risk of bleeding”, she warned.

Once you know the types of placenta previa, read on to see how to identify the condition and how the diagnosis is made.

How to identify placenta previa

According to the obstetrician, “in many cases, it is asymptomatic, in others, the pregnant woman may present with continuous or intermittent light red bleeding without pain”. The diagnosis “is basically made by obstetric or transvaginal ultrasound, however, it is worth mentioning, the exam is performed after 20 weeks of gestation”, she added.

How does placenta previa treatment work?

The Doctor. Rogério explained that it is not really a treatment, but rather the conduction and evolution of prenatal care, that is, the obstetrician will assess the condition of the pregnant woman. “In cases where the pregnant woman has a total central placenta, the woman cannot go into labor, and a cesarean section is indicated. Now, the marginal and semi-total placenta, the obstetrician will analyze the conditions for a normal delivery or not”.

In addition, depending on the diagnosis, which “is also made by magnetic resonance imaging to assess the depth of placental implantation, it may be necessary to perform puerperal hysterectomy and blood transfusion”. Another factor is the issue of prematurity, because “if there is continuous bleeding and there is fetal viability with lung vitality, delivery should be anticipated”, added the doctor.

5 precautions that a pregnant woman should take when she has placenta previa

There are some important precautions that the pregnant woman should take when she has placenta previa. The obstetrician cited some to avoid possible complications. Check out:

  • Physical activity: the specialist informed that the pregnant woman should avoid exaggeration. In this case, he advised not to do physical exercises and just walk, as instructed by the doctor”;
  • Sexual intercourse: according to Dr. Rogério, “the main care is not to have sexual intercourse because there is a risk of detachment and bleeding”;
  • Standing for a long time: “Staying for a long time is another care that any pregnant woman should have, especially those with a low placenta”, quoted the doctor;
  • Physical effort: it is not recommended to “make any kind of physical effort”, warned the specialist. So, it is necessary to avoid any activity that can trigger bleeding;
  • Vaginal examination: the obstetrician warns that “under no circumstances can vaginal examination be performed due to the risk of bleeding. The diagnosis must be made by ultrasound.

The specialist explained that measures such as “elevating the legs do not improve or prevent the prognosis. On the other hand, absence from work is only done in isolated cases, when it is necessary to hospitalize the patient due to continuous bleeding and associated pathologies”.

More questions about placenta previa answered by the obstetrician

Can people with placenta previa go into labor?

Rogério Tabert (RT): if it is total center placenta previa, no, absolute cesarean section is necessary. In the case of partial and marginal, it is up to the obstetric evaluation with the patient in respect to humanization and the strategy of the route of delivery.

Can anyone who has had it get pregnant again?

RT: It definitely can. Obviously, the incidence in those who have had it is a little higher and will be diagnosed after the twentieth week by ultrasound. However, there may be exceptions in cases of extremely high-risk pregnancies or miscarriages and major uterine malformations. Finally, under no circumstances can we discourage a woman from getting pregnant. This is humanization.

Are there any risks for the mother?

RT: due to continuous bleeding, hysterectomy surgery may be necessary and post-puerperal hysterectomy complications can even lead to death. It is not common, but post-operative bleeding can also occur.

Are there any risks for the baby?

RT: in the case of total center placenta previa, if there is continuous bleeding, it may be necessary to perform a cesarean section and remove the premature baby. So, bleeding or prematurity is the main cause of fetal complications.

How to sleep?

RT: The way you sleep doesn’t influence anything at all. Obviously, every pregnant woman is advised to sleep in the left lateral decubitus position (LED) to avoid compression of the artery. But, the pregnant woman can sleep in the right lateral decubitus position and belly up, from time to time. However, DLE is the most common.

It is worth emphasizing the importance of performing prenatal care, as it is thus possible to detect diseases that can affect the healthy development of the baby and complications that affect the health of the pregnant woman. Enjoy and learn more about hemorrhoids in pregnancy, what the symptoms are and how to prevent this nuisance.


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