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Placenta Previa – Is the Placenta Movable?
The placenta is the organ that nourishes the developing fetus. It provides the fetus with the blood supply and nutrients necessary for survival. It grows along with the pregnancy. During pregnancy, the placenta changes itself as the womb (uterus) stretches and grows. In early pregnancy, a low-lying placenta is very common. But as the pregnancy progresses, the placenta “moves” to the top of the uterus. By the third trimester, the placenta should be near the top of the uterus, making the opening to the cervix clear for delivery. If it still remains in the lowest part of the uterus and can cover the cervix, then we called this placenta previa.
The causes of Placenta Previa
Placenta previa occurs in 3-6 out of 1000 pregnancies. The exact cause of this complication is still unknown, but the frequency increases in women who have:
- Hereditary abnormal shape of the uterus
- Uterine fibroids or surgery to remove fibroids
- Scarring of the uterine wall caused by previous pregnancies, cesareans, uterine surgery, or abortion
- Multiple pregnancy (twins, triplets, etc.)
- History of placenta previa
Women who smoke or have their first pregnancy at an older age (above 35) may also have an increased risk. Possible causes of placenta previa are:
- Abnormal formation of the placenta
- Abnormal uterus
- Large placenta
- Scarred lining of the uterus (endometrium)
Diagnosis of Placenta Previa
The diagnosis of placenta previa is confirmed in the third trimester (7 months or 28 weeks). Before that, the situation is not significant, because the placenta is there normally. At the end of the second trimester or early third trimester, the low segment of the uterus is formed. This formation causes the “pulling” of the placenta to the top as explained above. This segment is larger, but also thinner. The muscle of this part cannot contract properly if there is a placenta previa. The enlargement of the empty segment of the uterus and the opening of the cervix sometimes causes the uterine sinus to tear. It can cause vaginal bleeding, the main symptom of placenta previa.
The bleeding is sudden, painful and often heavy. The bleeding may stop on its own, but may start again days or weeks later. Usually the second bleeding is heavier than the first; the third is stricter than the second, and so on. There may be uterine cramps with the blood. Labor sometimes starts within several days of heavy vaginal bleeding. In some cases, however, bleeding may not occur until after the onset of labor.
If a pregnant woman experiences these symptoms, the doctor will examine an ultrasound to confirm the diagnosis. The optimal assessment should of course be taken close to labor, to ensure where the position of the placenta is. So the decision on how the work will be carried out can be changed in the last minutes.
And so do not judge that diagnosis of placenta previa in early pregnancy is false positive, because you know how it can happen by reading this article.
Types of Placenta Previa
There are four types of placenta previa, according to the coverage of the opening of the cervix:
- Complete placenta previa: The placenta completely covers the cervical opening. In this situation, a normal labor cannot be carried out. It can cause severe bleeding and lead to death.
- Partial placenta previa: The placenta covers part of the cervical opening. It still has a high risk of bleeding during labor, so a woman in this condition is most likely to have a caesarean section.
- Marginal placenta previa: The placenta is close to the edge of the cervix but does not block it. Labor may be normal, but the risk of bleeding is still high. You have to be very careful.
- Low-lying placenta (also called lateral placenta or dangerous placenta): The placenta lies in the low part of the uterus a few millimeters or centimeters from the cervix. You can deliver the baby normally, but you have to be careful because there is still a risk of bleeding, but less than other types.
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