Is it serious if the lower edge covers the cervical opening?

The lower edge covering the cervical opening mainly occurs during labor. After it occurs, many mothers will feel very nervous, fearing that it will cause bad consequences to their bodies or make the delivery less smooth. In fact, in this case, you should adjust your mentality. Only by maintaining an optimistic attitude can you make your delivery smoother and without any risks.

1. Symptoms

The main symptom of placenta previa is painless, recurrent vaginal bleeding without cause in late pregnancy or during labor, which occasionally occurs around 20 weeks of pregnancy. Bleeding is caused by the gradual stretching of the lower uterine segment in late pregnancy or after labor, the disappearance of the cervical canal, or the dilation of the cervix, while the placenta attached to the lower uterine segment or the internal os of the cervix cannot stretch accordingly, causing the anterior part of the placenta to detach from its attachment point, causing rupture of the blood sinuses and bleeding. The initial bleeding amount is generally not much. After the blood at the dissection site coagulates, the bleeding can stop temporarily. Occasionally, there are cases where the initial bleeding amount is large.

As the lower uterine segment continues to stretch, bleeding often occurs repeatedly and the amount of bleeding increases. The early or late occurrence of vaginal bleeding, the number of times it recurs, and the amount of bleeding are closely related to the type of placenta previa. In complete placenta previa, the first bleeding often occurs early, around 28 weeks of pregnancy, and the bleeding is frequent and the amount is large. Sometimes a single large bleeding can put the patient into shock. In marginal placenta previa, the first bleeding occurs later, usually between 37 and 40 weeks of pregnancy or after labor, and the amount is also less. In partial placenta previa, the time of first bleeding and the amount of bleeding are between the above two. For patients with partial or marginal placenta previa, rupture of membranes is beneficial to the compression of the placenta by the fetal presenting part. If the fetal presenting part can descend quickly after rupture of membranes and directly compress the placenta, the bleeding can stop.

Due to repeated or heavy vaginal bleeding, the patient may develop anemia. The degree of anemia is proportional to the amount of bleeding. Severe bleeding may cause shock, fetal hypoxia, distress, or even death.

2. Physical signs

The patient's general condition depends on the amount of bleeding. When there is heavy bleeding, the patient may experience shock symptoms such as pale complexion, weak pulse, and low blood pressure. Abdominal examination: The size of the uterus is consistent with the number of weeks of amenorrhea. Because the placenta occupies the lower segment of the uterus, it affects the entry of the fetal presenting part into the pelvis, so the presenting part floats high. About 15% of cases have complications of abnormal fetal presentation, especially breech presentation. Examination during labor: Uterine contractions are paroxysmal, and the uterus can relax completely during the intervals. Sometimes a placental bruit can be heard above the pubic symphysis.