What is Placenta Previa? Everything Expecting Mothers Need to Know

Bleeding during pregnancy can be alarming, especially in the later months. In some cases, it may be linked to placenta previa, a condition where the placenta covers the cervix instead of attaching higher up in the uterus. This can lead to complications, particularly as the pregnancy progresses and the body prepares for birth. Early diagnosis is important, as the condition often requires careful monitoring and adjustments to daily activities. Understanding the symptoms, possible risks, and the best way to manage the condition can help ensure a safer pregnancy and delivery. This blog covers everything expecting mothers need to know about placenta previa.

What is Placenta Previa? 

Placenta previa is a condition where the placenta attaches lower in the uterus instead of the usual position higher up. This can partially or completely cover the cervix, the opening to the birth canal. The condition is usually detected during the second trimester through an ultrasound scan.

In early pregnancy, a low-lying placenta is common, but in most cases, it moves upwards as the uterus expands. If it remains low in the later months, it is diagnosed as placenta previa. This can lead to complications such as bleeding, particularly in the third trimester, and often requires careful monitoring. Depending on the severity, a caesarean section may be necessary for a safe delivery.

What are the Types of Placenta Previa?

Placenta previa is classified into different types based on how much of the cervix is covered by the placenta. This classification helps determine the level of risk and the most suitable delivery method. The three main types include:

Complete Placenta Previa

The placenta entirely covers the cervix, blocking the baby’s exit from the uterus. This is the most severe form and poses a high risk of bleeding, especially in the later months. As labour cannot progress safely, a caesarean section is required for delivery.

Partial Placenta Previa

The placenta covers part of the cervix but not entirely. In some cases, it may shift upwards as the uterus expands, reducing the risk of complications. However, if it remains in a low position, it can obstruct delivery, making a caesarean section necessary. Regular ultrasound scans help monitor any changes.

Marginal Placenta Previa

The placenta is located near the cervix but does not cover it. As the uterus grows, there is a chance that the placenta may move further away from the cervix, allowing for a vaginal delivery. However, if it remains too close, it may still lead to complications such as bleeding, requiring medical supervision throughout pregnancy.

What Causes Placenta Previa?

The exact cause of placenta previa is not always clear, but several factors may increase the likelihood of developing this condition.

• Previous uterine surgery or procedures – Scarring from a caesarean section, uterine surgery, or procedures like dilation and curettage (D&C) can affect placental implantation. The placenta may attach to the scarred area, increasing the risk of placenta previa.
• Multiple pregnancies – Carrying more than one baby increases the demand for placental attachment sites. With limited space, the placenta may implant lower in the uterus.
• Previous placenta previa – A history of placenta previa raises the likelihood of it occurring in future pregnancies. The uterus may have areas less suitable for implantation, leading to a repeated occurrence.
• Abnormalities in the uterus – Conditions such as fibroids or an irregularly shaped uterus can interfere with the placenta’s ability to attach higher in the uterus, resulting in a lower placement.
• Maternal age – Women over 35 have a higher chance of developing placenta previa. Age-related changes in the uterus may affect where the placenta implants.
• Smoking and substance use – Smoking or using certain substances during pregnancy can affect placental development and increase the risk of abnormal implantation.
• In vitro fertilisation (IVF) – Pregnancies conceived through IVF have a higher risk of placenta previa, possibly due to the way the embryo implants in the uterus.

What are the Symptoms of Placenta Previa?

The main symptom of placenta previa is painless vaginal bleeding, usually in the second or third trimester. The amount of bleeding can vary, ranging from light spotting to heavy bleeding. Other symptoms may include:

• Bleeding after intercourse – The cervix may become more sensitive due to the low-lying placenta, leading to bleeding following sexual activity.
• Episodes of bleeding that stop and return – Bleeding may occur intermittently rather than continuously. It can stop on its own and return later, often becoming heavier as the pregnancy progresses.
• Signs of preterm labour – Some women may experience contractions, backache, or pressure in the lower abdomen, which can indicate early labour.

Placenta previa does not usually cause pain, though some may feel mild cramping. Any vaginal bleeding during pregnancy should be reported to a doctor for evaluation.

What are the Risks and Complications of Placenta Previa?

Placenta previa can lead to serious complications, particularly in the later stages of pregnancy. The risks depend on the extent of placental coverage and the severity of bleeding. Some possible complications include:

• Heavy bleeding (haemorrhage) – As the cervix begins to thin or dilate, the blood vessels in the placenta may rupture, leading to severe bleeding. This can be dangerous for both the mother and baby, sometimes requiring an emergency caesarean section.
• Preterm birth – Persistent bleeding or complications may require an early delivery to protect the baby. Babies born before full term may face difficulties related to lung development, temperature regulation, and feeding.
• Placenta accreta – In some cases, the placenta attaches too deeply to the uterine wall, making it difficult to detach after birth. This increases the risk of severe bleeding and may require a hysterectomy to control blood loss.
• Fetal distress – Reduced oxygen and nutrient supply due to placental abnormalities can affect the baby's growth and well-being. Continuous monitoring is necessary to ensure the baby’s health.
• Anaemia due to blood loss – Repeated episodes of bleeding can lead to a drop in red blood cell levels, causing anaemia. This can result in fatigue, weakness, and other health concerns requiring medical management.
• Increased risk of infection – If bleeding occurs frequently, prolonged hospital stays and medical interventions may raise the risk of infections.
• Need for a caesarean section – In most cases, placenta previa prevents vaginal delivery, making a caesarean section necessary to avoid complications.

How is Placenta Previa Managed During Pregnancy?

Managing placenta previa involves careful monitoring and lifestyle adjustments to reduce risks and ensure a safe pregnancy. The approach depends on the severity of the condition, the amount of bleeding, and the stage of pregnancy.

• Limited physical activity – Avoiding heavy lifting, prolonged standing, and strenuous activities helps reduce the risk of bleeding. In some cases, bed rest may be recommended.
• Pelvic rest – Avoiding intercourse, douching, or any internal examinations (unless medically necessary) helps prevent irritation to the cervix and reduces bleeding risk.
• Regular ultrasound monitoring – Follow-up scans are scheduled to track placental position. In some cases, the placenta moves upward as the uterus expands, reducing complications.
• Hospitalisation for severe cases – If bleeding is heavy or frequent, hospital admission is necessary for close monitoring. This allows for immediate medical intervention if complications arise.
• Medical supervision for preterm birth risks – If early labour signs appear, doctors may recommend corticosteroid injections to help the baby’s lung development. In some cases, medication is given to delay contractions.
• Planned caesarean delivery – If the placenta remains too close to or covering the cervix, a caesarean section is scheduled before labour begins to ensure a safe delivery.

Following medical advice and attending regular check-ups help manage placenta previa effectively, reducing complications for both mother and baby.

When to Seek Medical Help?

Seeking medical help at the right time is crucial for managing placenta previa and preventing complications. Immediate medical attention is needed in the following situations:

• Vaginal bleeding – Any amount of bleeding, especially in the second or third trimester, should be reported to a doctor. Heavy or persistent bleeding requires urgent medical care.
• Severe abdominal pain or contractions – Intense pain or cramping may indicate complications such as placental detachment or early labour.
• Signs of shock – Symptoms like dizziness, fainting, rapid heartbeat, or pale skin suggest significant blood loss and require emergency treatment.
• Decreased fetal movement – A noticeable reduction in baby movements may indicate distress and should be checked immediately.

Regular check-ups and prompt medical attention for any unusual symptoms help manage placenta previa safely.

Consult Today

Managing placenta previa requires careful monitoring and timely medical support to ensure a safe outcome for both mother and baby. At Max Hospital, a team of experienced specialists provides comprehensive care for placenta previa, from diagnosis to delivery planning. If there are any concerns about symptoms, risks, or delivery options, consulting a OB-GYN specialist can provide the reassurance and guidance needed. Schedule an appointment at Max Hospital to discuss the best approach for a safe and healthy pregnancy.

Frequently Asked Questions

1. Can placenta previa be detected in early pregnancy?

Yes, placenta previa can be identified during an early ultrasound, usually in the first or second trimester. However, in many cases, the placenta moves higher as the uterus expands, resolving the condition by the later stages of pregnancy. Follow-up scans are done to monitor placental position as the pregnancy progresses.

2. Can placenta previa resolve on its own as pregnancy progresses?

In some cases, especially when diagnosed early, the placenta may shift upwards as the uterus grows. This is more likely if the placenta is only partially covering the cervix. However, if the placenta remains too low in the third trimester, it is unlikely to move and will require careful management.

3. Can placenta acreta be prevented by early interventions?

Yes, a good first trimester scan to detect the position of the gestational sac and using methods to get rid of a scan pregnancy helps in preventing placenta acreta. More study needs to be done in this field.

4. Are there any lifestyle changes that can help manage placenta previa?

Yes, certain lifestyle modifications can help reduce risks. These include avoiding strenuous activities, heavy lifting, and prolonged standing. Doctors may also recommend pelvic rest, which means avoiding intercourse or anything that could irritate the cervix. Regular medical check-ups are essential to track any changes.

5. Is placenta previa linked to any long-term health issues after delivery?

For most women, placenta previa does not cause long-term health problems once the baby is delivered. However, in cases of severe bleeding or placenta accreta (when the placenta attaches too deeply to the uterus), additional medical intervention may be required. Recovery depends on the severity of the condition and any complications during delivery.

6. Can placenta previa affect future pregnancies?

Having placenta previa once may slightly increase the risk of developing it in future pregnancies. The risk is higher for those who have had a caesarean section, as scar tissue can affect placental implantation. A doctor can provide guidance on managing risks in future pregnancies.

7. Does having placenta previa mean a longer hospital stay after delivery?

The length of the hospital stay depends on the severity of the condition and any complications during delivery. If there is significant blood loss or a complex caesarean section, additional monitoring may be needed. However, in uncomplicated cases, recovery time is similar to that of a routine caesarean birth.

8. How is placenta previa different from placental abruption?

Placenta previa occurs when the placenta covers the cervix, while placental abruption happens when the placenta detaches from the uterine wall before delivery. Placental abruption usually causes sudden, severe pain and bleeding, whereas placenta previa often leads to painless bleeding. Both conditions require medical attention, but their causes, risks, and management strategies differ.