Apr
09

          I feel so fortunate that I did not suffer any complications with either one of my pregnancies, particularly due to my age (41 with the last son).  Because of my age and the fact that I had previous cervical cancer and blood clots, I was a high risk patient with both pregnancies.  People do not realize that there are so many things that can go wrong with a pregnancy.  I’m surprised that mothers and babies were so healthy back in the era of my grandparents and before!  One very interesting diagnosis to watch carefully is placenta previa.  It occurs in about one in 200 pregnancies.  Women who’ve had a placenta previa in a previous pregnancy have a 4 to 8 percent chance of a recurrence.  According to the American Pregnancy Association, there are approximately 6 million pregnancies every year throughout the United States.  Of these pregnancies, approximately 4 million are live births and approximately 2 million of these pregnancies result in losses.  Further, each year in the United States, 875,000 women experience one or more pregnancy complications.

          Placenta previa is a problem with the placenta during pregnancy.  The placenta is a round, flat organ that forms during pregnancy to give the baby food and oxygen from the mother.  The placenta forms on the inside wall of the uterus soon after conception.  During a normal pregnancy, the placenta is attached higher up in the uterus, away from the cervix.  But in rare cases, the placenta forms low in the uterus.  If this happens, it may cover all or part of the cervix.  When the placenta blocks the cervix, it is called placenta previa.  This lower part is very thin compared to the upper part and this may prevent a normal vaginal delivery.  There are three types of placenta previa depending on how much of the cervical opening is covered.  Complete previa refers to the placenta covering the total opening of the cervix and blocks a vaginal delivery.  This is the most serious form of placenta previa.  Partial previa is diagnosed when the placenta covers a part of the opening of the cervix and blocks a vaginal delivery.  Low lying Placenta is when the placenta is at the edge of the opening. 

          The major symptom of placenta previa is bleeding from the vagina.  It is bright red and may increase with activity.  Some women also experience contractions.  Placenta previa is an emergency (life-threatening) and you should get medical advice right away.  If you start vaginal bleeding during pregnancy, your doctor will most likely do an ultrasound. This test can show the position and type of the placenta.  The doctor will explain the risks and may admit you to the hospital.  The kind of treatment you will have depends on how much you are bleeding, how the problem is affecting your health and your baby’s health and how close you are to your due date.  Chances are you will be put on bed rest in the hospital so that you can be monitored.  Bed rest helps prevent more bleeding and stretching of the cervix.  The goal is to keep you pregnant and allow more time for your baby to grow and develop.  You should also avoid any activity which could cause further bleeding, such as lifting, straining, sexual intercourse or use of tampons.  In addition, doctors always do a cesarean section when there is a placenta previa.  This is because the placenta can be disturbed with a vaginal delivery, and it can cause severe bleeding.

          Nursing care for the patient with placenta previa includes watching for more bleeding by counting the number of pads that are used and by paying close attention to the amount and color of the bleeding.  In addition, keeping the perineal area cleaned is very important to reduce the complication of any infection.  You will be constantly monitored, which will include listening to your baby’s heart beat and movement, checking your blood count, telling you about any upcoming tests and helping you with your daily care and activities while you are on bed rest.  Providing support and encouragement for you and your family are equally as important along with answering any questions that you and your family may have.

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