Placenta Previa

Plazentanın Aşağıya Yerleşmesi (Plasenta Previa)Placenta Settling Down (Placenta Previa)
It is a condition in which the placenta, the partner, is located lower down in the uterus, which can cause excessive bleeding. After fertilization, the placenta begins to form. The placenta takes oxygen and nutrients from the mother’s blood, allowing the baby to grow and develop. It is the structure that lies between the uterine wall and the baby and provides this relationship between the baby and the mother through the baby’s umbilical cord.
In early pregnancy, the placenta may be located below. As the uterus grows, the placenta moves upwards and settles away from the cervix. If this does not happen, the cervix closes and this is called placenta previa, or the placenta lying down.
If placenta previa is present, the placenta detaches from the lower part of the uterus when the cervix opens at the onset of labor. This can cause very serious bleeding. Fortunately, it is now very easy to detect placenta previa and it is possible to prevent dangerous situations before they occur.

What are the symptoms?
The main symptom of placenta previa is painless, red vaginal bleeding in the second half of pregnancy. Some women develop mild bleeding or spotting in the first trimester of pregnancy. However, placenta previa is diagnosed after 20 weeks of gestation. In terms of placenta previa, it is important to have bleeding in the last trimester. The amount of bleeding may be more or less. It usually resolves within a few days or weeks. Some pregnant women with placenta previa may have uterine contractions with bleeding.

How Many Types Are There?
There are three types of placenta previa;
– In total placenta previa, the placenta is completely covering the cervix.
– In partial placenta previa, the placenta partially covers the cervix.
– In marginal placenta previa, the placenta extends to the edge of the cervix.

Why does it happen?
Placenta previa develops when the placenta settles in the lower part of the uterus and grows to cover the cervix. Some conditions are thought to facilitate this. These conditions include
– Scar tissue in the uterus (previous curettage, previous cesarean section)
– The presence of a large placenta in cases such as multiple pregnancy
– Having an abnormal uterus (congenital uterine anomalies, shape abnormalities of the uterus)

What are the Risk Factors?
– Having had a cesarean section before
– Placenta previa in a previous pregnancy
– 35 years of age or older
– Smoking
– Having twins, triplets or more babies
– Interventions such as surgery or abortion that leave scar tissue in the uterus

When to see a doctor?
When you are pregnant, you should already visit your doctor at regular intervals. If you develop vaginal bleeding in the second or last trimester of your pregnancy, you should inform your doctor immediately. Your doctor will perform the necessary tests, especially ultrasound, to find out the cause of the bleeding.
If you have already been diagnosed with placenta previa, remind your doctor about this. This is because a gynecological examination can increase the intensity of the bleeding. Sexual intercourse is also prohibited until you have given birth.

How is it diagnosed?
Placenta previa is diagnosed with ultrasound. An abdominal ultrasound may not always be definitive and a transvaginal ultrasound may be needed. It can be detected during your normal check-ups or when you are being investigated after vaginal bleeding. The diagnosis is usually made before a dangerous situation develops for both mother and baby.

What can it lead to?
If you have been diagnosed with placenta previa, your doctor will monitor you and your baby closely to prevent problems. Problems that may occur include;
Bleeding. The most important problem that placenta previa can cause is vaginal bleeding. The severity of bleeding can put the life of the mother and baby at risk.
Premature birth. Severe vaginal bleeding may require an emergency caesarean section, even if your baby has not finished growing and developing.

How is it treated?
The treatment of placenta previa depends on many factors. The amount of vaginal bleeding, whether the bleeding continues, how many weeks your baby is, your health condition, your baby’s health condition, the placenta and the placement of the placenta and your baby are all factors that will affect the treatment.
➢ If there is little or no bleeding, only bed rest at home may be recommended. However, you will need to spend most of your time in bed. You are not allowed to have sexual intercourse. Exercise is also not appropriate. Remember to ask your doctor about other things you should and should not do.
➢ If your placenta is not covering your cervix, you may be allowed to give birth normally. However, if you develop severe bleeding, you may need an emergency caesarean section.
➢ If your bleeding is very severe, hospitalization may be necessary. If there is severe blood loss, you will receive a blood transfusion. You may be given medication to prevent preterm labor. A caesarean section is planned when your baby is ready. The ideal time is actually 36 weeks. However, it is not always possible to wait and an early caesarean section may be performed. In this case, cortisone injections may be given to help your baby’s lungs develop.
➢ If uncontrollable bleeding occurs during a caesarean section, special stitches may be placed in the uterus, a special balloon mechanism may be inserted into the uterus or the main vessels to the uterus may have to be ligated. In some cases, the uterus may need to be removed. If you have unstoppable bleeding, you will have an emergency caesarean section, even if your baby is premature.

What to do?
If you have been diagnosed with placenta previa, you will of course be concerned about how it will affect you and your baby’s health. Here are some points to help you with this.
Find out about your condition. Talk to your doctor and connect with women who have had placenta previa in previous pregnancies.
Be prepared to have a caesarean section. Placenta previa can prevent you from giving birth normally.
✔ If your doctor has recommended bed rest, strictly follow it.
✔ Remember that many pregnant women with placenta previa have healthy babies and take good care of yourself without getting depressed.

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