What is Placenta Previa?
Placenta previa occurs when the placenta covers some or all of the cervix during the last months of pregnancy. Although it is normal for the placenta to be low in the uterus early in a pregnancy, complications can arise if it eventually attaches to the lower part of the uterus. This can cause significant bleeding before or during delivery, which puts both mother and baby at risk.
What are the Symptoms of Placenta Previa?
The main symptom of placenta previa is sudden bleeding, which may be light or heavy. Bleeding can occur during pregnancy without a serious cause, but you must visit your doctor immediately so they can assess the cause of the bleeding. NJ Perinatal Associates has the latest technology that allows us to pinpoint the reason for the bleeding and provide appropriate care. Those with placenta previa may also notice:
- Cramps or sharp pains
- Intermittent bleeding that stops and begins again, days or weeks later
- Bleeding after intercourse
How is Placenta Previa Diagnosed?
Placenta previa may be noticed during a 20-week ultrasound, but a low-lying placenta often corrects itself by the end of the pregnancy. Bleeding in the second half of pregnancy will usually be monitored and diagnosed using transvaginal ultrasound, transabdominal ultrasound, or MRI.
How is Placenta Previa Treated?
Treatment methods for placenta previa will depend on the amount of bleeding, how far along you are in your pregnancy, and the health of your baby. In cases with very little bleeding, your doctor may recommend bed rest. Heavy bleeding may require hospital bed rest and medication to prevent preterm labor. If bleeding is uncontrollable, emergency cesarean delivery may be necessary.
What is Placental Abruption?
Placental abruption occurs when the placenta tears away from the wall of the uterus. This is extremely dangerous and can lead to the death of the child and mother. This condition is so concerning because when the placenta detaches, the baby may not be able to get enough oxygen or nutrients. This occurs in only 1% of pregnancies and it is the number one cause of bleeding after 20 weeks of pregnancy.
What are the Symptoms of Placental Abruption?
The main symptom of placental abruption is vaginal bleeding, but bleeding does not occur in all cases. You should contact your doctor immediately if you experience vaginal bleeding during your third trimester. Other symptoms that can occur with placental abruption, which often worsen over time, include:
- Stomach or back pain that occurs suddenly
- Uterine tenderness
How is Placental Abruption Diagnosed?
Placental abruption is diagnosed by your doctor during a physical exam and using an ultrasound. Blood tests and fetal monitoring may also be performed. Depending on the severity of your abruption, you may be able to rest at home, or you may be admitted to the hospital.
How is Placental Abruption Treated?
Your doctor will determine if your placental abruption is mild, moderate, or severe, which then determines your treatment. Mild abruption may only require medications to encourage your baby’s lung development, and you may be sent home to rest. If mild placental abruption occurs at or after 34 weeks of pregnancy, your doctor may choose to induce labor or perform a cesarean delivery. If the baby is properly developed, early delivery can reduce the risk of further complications. Moderate to severe placental abruption usually requires immediate delivery.
What is Vasa Previa?
Vasa previa is an extremely rare condition that can be quite dangerous, causing the death of 50% of undiagnosed babies. However, when the condition is detected during pregnancy, chances for survival are much higher. Vasa previa is caused by a complication in which fetal blood vessels cross or run near the internal orifice of the uterus. This can be caused by past cesarean section births, low-lying placentas, and in-vitro fertilization.
What are the Symptoms of Vasa Previa?
Many cases of vasa previa have no symptoms, and the condition is not detected until labor and delivery. You should contact your doctor immediately if you experience painless vaginal bleeding, as a sign of vasa previa is very dark red blood. Since the baby is naturally lower in oxygen, the fetus’s blood is darker than the mother’s blood.
How is Vasa Previa Diagnosed?
Vasa previa is very rare, so it is not usually screened for. However, at NJPA we ensure that those with risk factors during their pregnancy have access to the appropriate tests to promote their health and the health of their baby. Vasa previa can be detected using a transvaginal scan with a color Doppler. This allows the technician to see the direction and speed of blood flow and determine if any abnormalities are present.
How is Vasa Previa Treated?
When vasa previa is identified and diagnosed before delivery, proper management can be achieved, and the chances for the baby’s survival are very high. If you are diagnosed with vasa previa during your pregnancy, you will likely have regular ultrasounds to monitor the condition. The management of vasa previa aims to allow the pregnancy to progress for as long as possible. Some cases may require hospitalization for close monitoring and bed rest. Cesarean delivery between 35 and 37 weeks of pregnancy may also be recommended. This type of delivery allows your doctor to control aspects of the delivery that would not be possible during spontaneous labor.