Placenta previa

Placenta previa - causes, symptoms and treatment

The only symptoms that may indicate placenta previa during pregnancy are painless bleeding. They arise, as a rule, closer to the second half of pregnancy against a background of complete well-being.

Causes of placenta previa

Diagnosis of placenta previa by ultrasound, and the final diagnosis can be made after 24 weeks - before there is a chance that the placenta will change its position on its own. In addition to using ultrasound to determine the final diagnosis of "placenta previa," this method also makes it possible to determine the presentation options, the size and area of ??the placenta, the degree of detachment. The reasons for the occurrence of placenta previa in pregnancy may be changes in the mucosa of the inner wall of the uterus as a result of repeated abortions, inflammations or sexual infections that were transferred to this complicated delivery.

The location to this pathology is more common in women with uterine cavity deformations due to congenital anomalies or acquired (for example, as a result of uterine fibroids).

Even the diseases of the heart, liver or kidneys, accompanied by stagnant phenomena in the organs of the small pelvis (including uterus), can become the cause of placenta previa.

In addition, three times more common placenta previa in women who give birth is not the first time.

Depending on the location of the placenta, a low presentation (attachment) of the placenta is distinguished, complete (central) or partial presentation (may be lateral or marginal).

Low placenta previa

In the normal course of pregnancy, the placenta is located on the bottom or the body of the uterus, along the anterior (rarely posterior) wall with the transition to the lateral walls. Low placenta previa is characterized by a situation where the placenta is located in the immediate vicinity of the internal throat of the cervix - at a distance of 6 cm and even less.

Determine this pathology most often in the second trimester of pregnancy when carrying out another ultrasound. But at the same time, if a low placenta previa has been diagnosed in this period, there is a possibility that with time, as the pregnancy progresses, the placenta will assume a "normal position".

Conditionally, this state of affairs is called "migration", and the movement of the placenta is caused by stretching and stretching the tissues of the uterus. So, as the fetus develops, The elastic tissues of the lower part of the uterus gradually rise upward. At the same time, some upward movement of the placenta takes place, due to which its location becomes normal. Therefore, if the low location of the placenta was found in the second trimester of pregnancy, there is a fairly high probability of its movement towards the end of pregnancy and the normalization of the situation.

Edge presentation of the placenta

Partial, or incomplete presentation of the placenta is the location in which the inner uterine uterus of the placenta is blocked, but not completely. One type of partial presentation of the placenta is the regional placenta previa.

In the marginal position of the placenta, its lower edge is at the level of the edge of the inner throat, while the exit orifice of the uterus is covered with a placenta tissue by about a third.

Usually, a marginal presentation of the placenta in the second trimester of pregnancy is diagnosed with the help of ultrasound, against the background of the pregnant woman's complaints about permanent bleeding. If the edge presentation of the placenta has been determined, the woman needs careful medical supervision and all necessary research. As necessary, iron-containing preparations can be prescribed - to avoid bleeding and the development of anemia due to a decrease in hemoglobin.

Full placenta previa (central placenta previa)

Complete placenta previa is probably the most serious pathology associated with abnormal placental location. About full praise, they say then, when the placenta completely closes the internal pharynx, during the vaginal examination the placental tissue is determined everywhere, the fetal membranes are not probed. If, moreover, it is possible to establish that the center of the placenta is located at the level of the throat, the diagnosis is "central placenta previa".

Partial presentation of the placenta is diagnosed with a frequency of 70-80% of the total number of presentations. At the same time, the full presentation takes place in 20-30% of cases, and this, unfortunately, is quite a considerable indicator.

With full placenta previa, a woman, even in the absence of bleeding, must be sent to a hospital. Diagnosed central presentation - a serious pathology, in which a pregnant woman should be provided with permanent qualified medical supervision.

Treatment of placenta previa

If a presentation has been found, it will be determined with a treatment regimen and the subsequent actions of the doctor will be based on the specificity of the placenta previa. But, however, in the case when the pregnant woman was diagnosed with placenta previa, she would need constant observation of specialists.

If bleeding is not observed, it may be possible to observe the expectant mother on an outpatient basis. In this case, it must avoid the stresses - both physical and emotional, exclude sex, sleep at least 8 hours a day and walk as much as possible. It will take a special diet, which assumes the consumption of foods rich in iron, protein and vitamins. Diet is necessary for the maximum intake of pregnant substances in the body: with the placenta previa, some of it does not participate in gas exchange, which can provoke hypoxia in the fetus. In the meantime, mummy may have anemia or low blood pressure, which also becomes a consequence of placenta previa during pregnancy.

If, at a period after 24 weeks, the pregnant woman has periodic bleeding, she will be offered to go to the hospital, where she can always provide emergency help in case of possible complications. In this case, it is recommended to observe hospital doctors permanently until the end of pregnancy. If bleeding is insignificant, and the woman's health has not worsened, resort to conservative methods of treatment: the pregnant woman is prescribed a bed rest, complete rest, drugs that reduce the tone of the uterus and improve blood circulation. If an anemia in the future mummy is found, she is prescribed drugs to increase the level of hemoglobin, as well as funds for general strengthening of the body.

Births with placenta presentation

Placenta presentation in pregnancy is an indication for delivery by cesarean section, in the case of full presentation - it is necessary, because other ways of delivery are impossible. If the pregnancy was saved, then cesarean is carried out at a period of 38-39 weeks.

With incomplete placenta previa, births are possible naturally, but they involve a certain risk. In addition, for natural births with incomplete presentation of the placenta, compulsory cessation of bleeding after the opening of the bladder, mature cervix, good labor and fetal head presentation become mandatory conditions. In other cases, if the birth will occur naturally, there is a high risk of complete detachment of the placenta, which will lead to very heavy bleeding. And it is fraught with serious complications - up to a lethal outcome for both the mother and the baby.

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