Symptoms of Placenta Previa: Symptoms, signs and causes of placenta previa
Before we discuss the symptoms of placenta previa let;s first define the term "placenta previa". Placenta Previa is a placenta that is placed in an abnormal place in the lower uterine segment partially or completely. It is liable for premature separation and bleeding.
There are maternal causes and fetal causes. Placenta previa is more common in old, multipara (women who have had multiple pregnanies before), anemic women.
Previous history of C-section more than 4 times or D&C as well as history of placenta previa are common risk factors as they are associated with uterine scarring.
It is also more common in multiple pregnancies, Diabetes and Rh incompatibility. There are multiple types including Placenta previa lateralis, marginalis, incomplete and complete placenta previa centralis )these are the fetal causes).
Symptoms of placenta previa
- Recurrent vaginal bleeding. The bleeding result from premature separation of the placenta from the wall of the uterus which causes tearing of some blood vessels. The amount of bleeding is variable, some times it is just mild but it can also be severe. The source of the blood is mainly maternal.
The bleeding can be a one time event and it can be painful sometimes.
- The bleeding may lead to pallor and anemia if severe enough. There is not abdominal pains or tenderness.
- The fetal heart sounds test is usually normal, the problem is mainly maternal due to the blood loss. Malpresentation is a common problem with placenta previa.
- The local examination should be limited and with the right precautions (in an operation room and the doctor should be ready to perform a cesarean section because the general examination in case of placenta previa can cause the bleeding.
Diagnosis and treatment of placenta previa
The main investigation in this case is ultrasonography, it gives an accurate diagnosis for the case and it is totally safe. An MRI can also be done as well as fetal wellbeing tests to check the status of the fetus.
Placenta previa has to be diagnosed and differentiated from other conditions that might cause antepartum bleeding such as accidental hemorrhage, a more dangerous condition that result from premature separation of a placenta in its normal site.
Management of placenta previa:
The treatment and delivery options are variable and different for each case. It depends on the type of placenta previa, the degree of bleeding and time.
In most cases, delivery is done with a C-Section operation (specially in the complete centralis type, also called type IV) as it is better for the fetus and allows faster control of the bleeding. Blood transfusion may be needed in case of severe blood loss and the patient should be admitted to hospital with bed rest and steroids given to help the maturation of the baby's lungs.