Placenta previa is considered a complication of the second trimester of pregnancy, because it is when the neck begins to have modifications by contractions, such as effacement, segment formation and finally dilation, which occurs at the site of placental insertion. They produce rupture of blood vessels or placental detachment that can cause severe hemorrhages with disastrous consequences for the baby and the mother.
Signs and Symptoms
- bleeding after 24 weeks of gestation.
- Fetus in an oblique, transverse or breech presentation because of the abnormal position of the placenta.
- If it is about the age of 35
- You have had more than four pregnancies
- Have a history of uterine surgery (regardless of the type of incision)
- Multiple pregnancies in which the area of insertion of the placenta in successive pregnancies is being replaced by scar tissue, subtracting land suitable for the implantation of the usual area.
- Advanced maternal age
- Uterine scars produced by previous surgeries: cesarean sections or operations due to uterine malformations.
- Uterine abnormalities that prevent the normal implantation of the placenta.
- Multiple pregnancies (two or more fetuses).
- Cocaine consumption
- Previous, spontaneous or provoked abortions.
It is performed by using a transabdominal ultrasound. The differential diagnosis between a placenta previa and a premature detachment of placenta is done very precisely with the vaginal ultrasound.
Treatment and Management
- Monitoring of the fetal heart is needed for those who are diagnosed with Placenta previa.
- In placenta previa, it is common for bleeding to be abundant, without pain and the blood is brighter than in the premature detachment of the placenta, but clinically differentiation is not possible.
- It must be determined how urgent delivery is, this is known with the monitoring of the fetal heart to detect if there is fetal distress, also it requires a sample of amniotic fluid to assess the lung maturity of the fetus.
- If the bleeding is before 34 weeks, it will be considered to indicate corticosteroids to accelerate lung maturity. If the 2nd episode of bleeding occurs, patients are readmitted to the hospital and remain under observation until the baby is born.
- Advance delivery is indicated when bleeding is severe, the mother or fetus is unstable or if fetal lung maturity is confirmed.