Placenta previa, how much do you know?

Placenta previa is a pregnancy complication that refers to the abnormal position of the placenta in the uterus. This article aims to improve readers' understanding and treatment of this condition by explaining the diagnosis, management and treatment strategies of placenta previa.

1. What is placenta previa

Placenta previa is when the placenta is located in the uterus closer to the cervix than normal, closer to the birth path of the fetus. Normally, the placenta is attached to the upper or side walls of the uterus, away from the cervix. In pregnant women with placenta previa, the placenta is abnormally located, close to the cervix or sometimes even covering the cervix.

Placenta previa is one of the serious complications of pregnancy, usually occurring in the third trimester. Academic studies have found that placenta previa is one of the main causes of bleeding in the third trimester of pregnancy. Improper treatment can endanger the life safety of mother and child. The domestic incidence rate is 0.24% to 1.57%, while the incidence rate abroad is about 1.0%. About 85% to 90% of patients with placenta previa are multiparous women, especially multiparous women, whose incidence rate can be as high as 5%. Therefore, strict management and monitoring are critical for pregnant women with placenta previa.

The exact cause of placenta previa is unknown, but some risk factors have been identified, such as previous pregnancy, advanced age, and previous cervical surgery, which may increase the chances of developing placenta previa.

Pregnant women who are found to have placenta previa need close monitoring and regular prenatal examinations, and decide the most appropriate method of delivery under the guidance of a doctor. For patients with severe placenta previa, cesarean section is a common choice to reduce the risk of delivery complications.

2. Diagnostic criteria, common symptoms and signs of placenta previa

The diagnosis of placenta previa relies on clinical manifestations and imaging examinations.

Diagnostic criteria:

1. Imaging examination: Ultrasound examination is used to confirm the position of the placenta, which is usually performed when the pregnant woman is 18-20 weeks pregnant or when vaginal bleeding occurs. It should be noted that when diagnosing placenta previa, it is necessary to avoid manipulative examinations such as vaginal examination, anal examination or endocervical examination, as these manipulative examinations may put pressure on the blood supply of the placenta and increase the risk of detachment.

2. Confirm the diagnosis: Based on the results of ultrasound examination, if the placenta is found to be in an abnormal position, especially if the placenta completely or partially covers the cervical opening, it can be confirmed as placenta previa.

Common symptoms and signs:

1. Vaginal bleeding: It is the most common symptom of placenta previa. The bleeding may be intermittent, small or large, and may be bright red or dark red.

2. Abdominal pain: Placenta previa may be accompanied by mild to severe abdominal pain, the severity and frequency of which vary from person to person.

3. Anemia in pregnant women: Heavy vaginal bleeding may cause anemia in pregnant women, which manifests as symptoms such as weakness, fatigue, and dizziness.

4. Shock in pregnant women: In rare cases, heavy bleeding may cause shock symptoms in pregnant women, such as increased heart rate, decreased blood pressure, loss of consciousness, etc.

It should be noted that the symptoms and signs of placenta previa may vary from person to person, and some pregnant women may not show obvious symptoms. Therefore, regular prenatal examinations and ultrasound examinations are very important for early detection and timely treatment of placenta previa. If vaginal bleeding, abdominal pain or other abnormal symptoms occur, pregnant women should seek medical attention and report to the doctor in time for evaluation and treatment.

Management and treatment strategies for placenta previa

1. Rest quietly: For patients with mild bleeding and no obvious symptoms, it is recommended to rest quietly and avoid or reduce physical activity. In addition, sexual life should also be avoided to reduce the risk of bleeding.

2. Hospitalization for observation: For patients with heavy bleeding or severe abdominal pain, hospitalization for observation is recommended, and the condition of the pregnant woman and fetus should be closely monitored. If necessary, blood transfusion or hemostatic drug treatment can be adopted.

3. Cesarean section: For patients with complete placenta previa or continued bleeding, and critical maternal and fetal conditions, cesarean section is a safe option. When choosing a cesarean section, factors such as the condition of the fetus and the mother's gestational age need to be considered, and appropriate pre-pregnancy/antenatal preparations should be made.

4. Emergency surgery: For patients who develop placenta previa earlier in pregnancy and have severe symptoms, emergency surgery such as cervical dilation and cesarean section may be required. The purpose of these surgeries is to complete delivery as soon as possible in the case of dystocia or placental abruption, and to protect the life and health of the mother and fetus. However, it should be noted that cervical dilation is not suitable for all patients with placenta previa, and decisions need to be made based on specific circumstances.

In short, placenta previa is a serious pregnancy complication that poses a major threat to the life and health of pregnant women and fetuses. Early diagnosis and comprehensive and effective treatment strategies can reduce the risk of complications and improve the survival rate and quality of life of mothers and infants. After confirming placenta previa, an individualized management and treatment plan needs to be developed based on the condition, the state of the pregnant woman and the fetus, and other factors. In any treatment, protecting the safety of the mother and baby is the primary consideration and needs to be handled under the guidance of a doctor. The views in this article are personal suggestions and are for reference only. For specific treatment or care, please follow the doctor's advice based on your individual circumstances. (Sun Xiaona, Shijiazhuang Maternal and Child Health Hospital, Hebei Province)