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Placenta PreviaWhen you hear the word placenta previa you might think it is a disease of the placenta. But this is not true. Actually, by this word we mean where the placenta is placed and not its condition. Usually, in placenta previa, the placenta is close to the lower half of the uterus. This may result in covering the mouth of the uterus, partially or fully. A placenta located at the bottom of the uterus is common in early stages of pregnancy. But it's usually observed that as the pregnancy advances, it moves to the upper side of the uterus. Even when this does not happen, as long as it’s not touching the cervical os there is nothing to worry. But, remember you can get problems in the last stages of delivery as well as on delivery in rare occasions. The closer to the os the placenta is, the greater the chances of hemorrhage. Keep in mind that vaginal delivery will be almost impossible if the placenta obstruct or cover the cervix completely or partially. It is often observed that women who have developed scars in their uterine wall from previous pregnancies, uterine surgery, cesareans, or D and Cs following miscarriage have a greater risk to have placenta previa. Some women may want a bigger placenta for their babies due to a higher need for oxygen or nutrients by the fetus. These usually happen if the mother has a smoking habit, have more than one fetus or lives in a higher altitude. It’s often found that the risk of placenta previa also increases as the placenta grows bigger. The most common symptom of placenta previa is painless bleeding. This occurs as the placenta moves to the lower portion of the uterus. Sometimes, this bleeding is found to occur before the twenty eighth week of pregnancy itself. But, with the majority of women with placenta previa, bleeding happen amid the 34th and 38th week. Even though painless bleeding is the most common symptom of placenta previa a projected 7 to 30 percent of women with placenta previa don’t show any bleeding at all before delivery. The bleeding associated with placenta previa is usually painless, bright red, and impulsive in nature. Keep in mind that this bleeding can also be caused by sexual intercourse, coughing or straining. It can be very irregular in the quantity of blood expelled and may stop suddenly and come back later. Fetuses with placentas in the lower part of the uterus find it difficult to "drop" into the pelvis prior to delivery. Some women with placenta previa do not show any symptoms at all and it may be difficult to know if they have placenta previa until the actual delivery happens or an ultrasound scan of the abdomen is performed on them. Usually, if bleeding is present, in order to confirm placenta previa an ultrasound scan is recommended. Before the 20th week of pregnancy, no treatment is needed for placenta previa as the placenta will move to the correct position by itself and will be cured naturally without causing any complications. After the 20th week, a mother with a known case of placenta previa may be required to take bed rest and her activity schedule also may need to get changed. Whenever bleeding is there, hospitalization is a must so that the condition of mother and baby can be evaluated closely. Try to calm her as far as you can. In case the bleeding is very light or stops, you can make the treatment traditional. This consists of careful monitoring, hospitalization, supplementation with vitamin C and iron, bed rest, and blood transfusions if needed until the fetus get strong enough for delivery. When you are diagnosed with placenta previa, straining at the toilet should be avoided at all costs. For this, you are highly recommended to use a diet which is high in fiber with stool softeners. You may be allowed to go home if there is no bleeding for a week. But remember, for this to be practical you should be staying near to the hospital and it should not take you more than 15 minutes to reach the hospital in case of an emergency. Also make sure that you take complete bed rest and have someone with you 24 hours who can drive you to the hospital if the need arises. Effort should be taken in order to extend the pregnancy until at least 36 weeks. Once the baby completes this age and his lungs are mature enough, a cesarean can be performed on the mother and the baby may be delivered. Cesarean is recommended to prevent massive hemorrhage. But, if before 36 weeks bleeding poses a life threat to either mother or baby, delivery should not be extended anymore and should be carried out immediately even if the baby is premature. Approximately, 75% of women with placenta previa will be delivered by cesarean. If placenta previa isn’t diagnosed until labor has begun and the placenta is not blocking the cervix and also bleeding is mild, a vaginal delivery may be attempted. Either be the case, usually mother or baby is going to be fine. Although placenta previa was a serious threat in the past, nearly 99% of mothers today deliver healthy babies today even if they are diagnosed with it. Pregnancy Week To Week 1- 40
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