Low Lying Placenta

Definition

The placenta is an organ that develops in a woman’s womb during pregnancy. It is also responsible for providing oxygen and food for the developing fetus. Low lying placenta which is also termed as placenta previa is a pregnancy complication that involves the placenta, the entire or a part of the cervix in the last few months of pregnancy. The condition is found in approximately 4 out of 1000 pregnancies.

Low Lying Placenta is divided into different types depending on its severity. These are:

• Complete placenta previa, it is when the placenta covers the entire opening starting from the uterus to the cervix
• Partial placenta previa, it is when the placenta covers a limited part of the cervical opening
• Marginal placenta previa, the placenta is close to the cervical opening without covering it.

Symptoms of Low Lying Placenta

The primary symptom of a low-lying placenta is vaginal bleeding ranging from light to heavy. The sudden bleeding is usually painless but in some cases, it may be associated with an abdominal pain and uterine contractions.

Other possible symptoms that need an immediate medical attention are:

• Bleeding after a sexual intercourse with the partner
• Cramps
• Bleeding that suddenly starts, stops, and sometimes begins again after a couple of days or weeks
• Bleeding that can occur at the start of the third trimester or perhaps at the end of second trimester

If the patient manifests severe bleeding, other possible symptoms may occur such as:

• Low blood pressure
• Anemia
• Breathing problems
• Weak and rapid pulse rate
• Pale skin

Causes

The main cause of a low lying placenta is usually not known, although there are numerous of factors that could increase the chance of developing it. In some other cases of women who have the condition, placenta previa occurs when the placenta increases in size due to the need for greater function or to make up for the decreased function.

Examples of women who are more at risk of placenta previa include those who are:

• Pregnant with one or more babies
• Advanced maternal age
• Smoking
• Have had children previously
• Have had any type of surgery on the placenta like a cesarean section
• Living at a high altitude

Diagnosis

If a woman experiences any vaginal bleeding in the second or third trimester of pregnancy, physicians will check the position of the placenta with either of the following:

• Magnetic Resonance Imaging (MRI) Scan which is an imaging test that can help in determining the exact location of the placenta
• Transvaginal ultrasound which is considered to be the most accurate and preferred method of diagnosing a low-lying placenta. The procedure makes use of a probe placed inside the vagina and its purpose is to produce inside images of the cervix and vaginal canal.
• Transabdominal ultrasound that is used in assessing the pelvic organs by placing a certain gel on the abdomen.

Treatment

About 90% of cases with placenta previa usually resolve on their own which means that treatment is often not required, unless certain other complications are present. Treating a low-lying placenta will vary on several factors including:

• Health of both the mother and the baby
• Amount of bleeding
• Position of the baby and the placenta
• Month of the mother’s pregnancy
• Minimal or No Bleeding

In cases of mothers with a low-lying placenta who are experiencing a minimal or no bleeding, the physician will recommend bed rest, which means that the patient should rest in bed without sitting or standing if absolutely necessary. The patient will also be asked to avoid any sexual intercourse and exercises. If in case bleeding occurs, a prompt medical care is required.

Heavy Bleeding

In cases of heavy bleeding, the patient may be suggested on any of the following:

• Hospital bed rest  is needed and the heart rate of the baby will be monitored as well as the blood loss
• Blood transfusions in cases where there is too much quantity of blood lost
• Medications that can help prevent premature labor
• C-section delivery which will be scheduled by the physician as soon as it is already safe for the mother to deliver the baby. If the C-section has to be scheduled a little sooner, the baby might be given corticosteroid injections in order to speed up lung growth.

Uncontrollable Bleeding

• For cases of uncontrolled bleeding, an urgent C-section will have to be done.

Complications

If a mother has a low lying placenta, the physician will observe her and the baby to reduce the possibility of the following complications that may occur:

• Internal bleeding
• Emergency Cesarean section
• Severe hemorrhaging during or after delivery

References:

• http://www.healthline.com/health/placenta-previa#Overview1
• http://www.webmd.com/baby/understanding-placenta-previa-basics
• http://www.webmd.boots.com/pregnancy/guide/placenta-praevia-low-lying-placenta
• Allen BC, Leyendecker JR (2013 Nov). Placental evaluation with magnetic resonance. Radiol Clin North Am. 51(6):955-66.
• Marshall NE, Fu R, Guise JM (2011 Sep). Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol. 205(3): 262. e1-8.
• Zlatnik MG, Cheng YW, Norton ME, Thiet MP, Caughey AB (2007 Oct). Placenta previa and the risk of preterm delivery. J Matern Fetal Neonatal Med. 20(10):719-23.