Marginal placenta caesarean section at several weeks

Because every woman's pregnancy is different, the position of the baby in the mother's belly is also different. There is a condition called marginal placenta. In this case, when the pregnant woman is close to the due date, she is likely to experience lower body bleeding, so if she chooses to give birth naturally, the delivery will be more difficult. Therefore, women with marginal placenta will choose cesarean section. So in which week is it best to perform cesarean section?

A type of placenta previa, marginal placenta previa, when the ultrasound is taken at 20 and 32 weeks, the edge of the placenta is inside the cervical os. In a normal pregnancy, the placenta is attached to the anterior, posterior and lateral walls of the uterus. If the placenta is attached to the lower part of the uterus, covering, partially covering, or very close to the internal os of the cervix, so that the position of the placenta is lower than the presenting part of the fetus, it is called placenta previa. Placenta previa is one of the main causes of bleeding in late pregnancy. If not handled properly, it can endanger the lives of mother and child. If it is discovered early, the specific treatment plan can be determined according to the clinician's advice, based on a comprehensive consideration of factors such as the type and location of placenta previa, the condition of the fetus, and the condition of the pregnant woman. Unfortunately, there is no way to help the placenta grow upward. If the pregnancy can be continued, the woman should be closely observed, get enough rest, and avoid abdominal pressure. In the late stages of pregnancy, it is best to be hospitalized for close observation and absolute bed rest. It is best to maintain the pregnancy until 37 weeks before giving birth. If heavy vaginal bleeding or repeated bleeding occurs during the observation period, the amount of bleeding increases, or labor has begun, the pregnancy must be terminated. In most cases, the method of delivery is cesarean section.

definition

The normal attachment site of the placenta is on the posterior, anterior or lateral wall of the uterine body. If the placenta is attached to the lower part of the uterus or covers the internal os of the cervix and is lower than the presenting part of the fetus, it is called placenta previa. Placenta previa is one of the main causes of bleeding in late pregnancy and a serious complication during pregnancy. It is more common in multiparous women, especially multiparous women.

Causes

It is not yet clear. It may be related to the following factors:

① An imperfect endometrium, puerperal infection, multiple births, IUD insertion, multiple curettages, cesarean sections and other surgeries can cause endometritis, endometrial defects, and insufficient blood supply. In order to absorb enough nutrients, the placenta compensatorily expands its area and extends to the lower segment of the uterus.

② The fertilized egg develops slowly, and when it reaches the uterine cavity, the trophoblast has not yet developed to the stage where it can implant, so it continues to be transplanted into the lower segment of the uterus.

③ The placenta area is too large. For example, most gestational discs often extend to the lower part of the uterus.

symptom

Painless, recurrent vaginal bleeding in late pregnancy or during labor is the main symptom of placenta previa, which occasionally occurs at 20 weeks of pregnancy. The early or late occurrence of vaginal bleeding, the number of recurrences, and the amount of bleeding are closely related to the type of placenta previa. The first bleeding of complete placenta previa often occurs early, around 28 weeks of pregnancy, and the bleeding is frequent and the amount is large. Sometimes a single large amount of bleeding can put the patient into shock. The first bleeding of marginal placenta previa occurs later, usually between 37 and 40 weeks of pregnancy or after delivery, and the amount is also less. The time of first bleeding and the amount of bleeding of partial placenta previa are between the two. With each contraction after labor, the lower segment of the uterus is pulled upward and bleeding often increases. In patients with partial and marginal placenta previa, if the fetal presenting part can descend quickly after rupture of membranes and directly compress the placenta, bleeding can stop. Rupture of membranes facilitates compression of the placenta by the presenting fetus. Due to repeated or heavy vaginal bleeding, the mother may develop anemia, the degree of which is proportional to the amount of bleeding. Severe bleeding may cause shock, and the fetus may suffer from hypoxia, distress, and even death.