During pregnancy, it is important to observe the correct development of the placenta, since it is the main nutrient for the unborn child, and the correctness of its location is the guarantee of the normal course of pregnancy right up until delivery. Normally, the placenta is located in the area of the body or the bottom of the uterus, along the back wall, with the transition to the lateral, as in these areas blood flow is best. Slightly less often the placenta may be located on the front wall, since it is more subject to changes than the posterior one.
Placenta previa is a pathology that is characterized by abnormal attachment of the placenta to the walls in the lower parts of the uterus, while overlapping the area of the internal pharynx.
Types of placenta praevia
- low location of the placenta - not overlapping the area of the internal throat, the edge of the placenta is located at a lower level than should be normal;
- complete (or central) presentation of the placenta - the area of the internal throat is completely blocked by the placenta;
- incomplete (or partial) presentation of the placenta - the placenta covers part of the internal uterine throat.
Incomplete presentation of the placenta in turn is divided into:
- marginal - the lower edge of the placenta is located at the level of the edge of the internal pharynx;
- lateral - the edge of the placenta partially covers the inner pharynx.
Placenta previa - causes
Dystrophic changes in the mucous membrane of the uterus may become the main reason for the occurrence of placenta previa during pregnancy. This is possible as a result of previous abortions, sexual infections, inflammations or due to postpartum septic diseases. The causes of this pathology can also be heart, kidney or liver disease. It should be noted that most often placenta previa occurs in women who give birth not the first time.
Placenta previa - symptoms
This pathology, as it is not strange, can be asymptomatic. But nevertheless, the main symptom in the presence of placenta previa is bleeding. This can be explained by the fact that placental tissue is not elastic, so it can exfoliate when the uterus is stretched, resulting in bleeding. As a rule, this symptom runs painlessly and can suddenly stop, but after a while, arise again.
Another symptom of placenta previa may be fetal hypoxia. The degree of hypoxia depends on the size of the placental abruption, as a result of which the exfoliated part ceases to participate in the utero-placental circulation system. Precisely determine the placenta previa or its low attachment is possible during an ultrasound examination.
Placenta previa - treatment
If a placenta is present, the pregnant woman should be under constant medical supervision. Treatment depends on the availability, duration and strength of bloody discharge. In case of bleeding during pregnancy beyond 24 weeks, treatment is carried out in a hospital where bed rest is recommended, in addition, preparations are prescribed to reduce the tone of the uterus and improve blood circulation. In cases where bloody discharge is not observed, a woman can be at home. But, certainly, you should avoid emotional and physical exertion, and also exclude sexual contact. It is necessary to spend more time in the open air, rest and eat well.
Births with placenta praevia
Spontaneous delivery is not possible with full placenta previa. Cesarean section surgery is routinely performed at a period of 38 weeks, even in the absence of bloody discharge.
It is possible to complete the birth naturally by partial presentation of the placenta, but the final decision on delivery will be taken by the doctor when the cervix opens up to 5-6 cm. If the partial presentation is small and spotting is insignificant, an opening of the fetal bladder is performed. As a result, the baby's head descends and squeezes the blood vessels that bleed. In this case, spontaneous labor is possible, but if the manipulations performed are ineffective, the labor is completed promptly.