Understanding Placenta Praevia and C-Sections
Placenta praevia is a condition in which the placenta partially or fully covers the cervix, and it can impact both pregnancy and delivery. Exploring the causes, implications for cesarean sections, recurrence risks, and precautions can provide insights for expectant mothers navigating this condition.
What is Placenta Praevia?
In the majority of pregnancies, the placenta attaches to the front or back of the womb (the uterus). However, in some cases, it may attach lower down and cover a part or all of the cervix (the entrance to the womb).
Depending on the position of the placenta, this condition is referred to as placenta praevia or low-lying placenta.
What is the cause of placenta praevia?
Placenta praevia may result from factors such as previous c-sections, advanced maternal age, or multiple pregnancies. Diagnosis involves ultrasound scans to determine the placental position and assess potential risks.
How is placenta praevia diagnosed?
If your placenta is found to be low-lying during your 18-20-week scan, you will be scheduled for another scan at around 32 weeks. This follow-up scan may involve a transvaginal ultrasound to determine the exact position of your placenta.
This procedure is safe for both you and your baby. Additionally, your cervix length will be measured at the 32-week scan to assess the risk of early labour and potential bleeding complications.
If the placenta remains low at 32 weeks, you will be offered another ultrasound at 36 weeks. The results of these scans will help you and your doctor plan the safest delivery method based on your specific circumstances.
Will I need to have a c-section?
If heavy bleeding occurs before your due date, it may be necessary to deliver the baby early. If the edge of the placenta is very close (less than 2cm) to the cervix, a c-section is the safest way to give birth.
This is because the placenta may be blocking the birth canal or to prevent heavy bleeding during birth. A c-section may be recommended between 36 and 37 weeks. However, if there has been vaginal bleeding during the pregnancy, an earlier c-section may be advised.
If the placenta is further than 2cm from the cervix, a vaginal birth may be possible if desired. During a c-section, a senior obstetrician (a doctor who specialises in pregnancy) will be present due to the risk of heavy bleeding during the surgery.
A blood transfusion may be needed in this case, especially with placenta previa. If you prefer not to have a blood transfusion, please inform your healthcare team as soon as possible.
If you’ve had placenta praevia before, what are your chances of having it again?
Women who have experienced placenta praevia in a previous pregnancy have an increased risk of recurrence in subsequent pregnancies, requiring close monitoring and specialised care.
Is there anything you should avoid if you have placenta praevia?
To minimise risks associated with placenta praevia, healthcare providers may advise avoiding activities that can trigger bleeding, such as heavy lifting, strenuous exercise, or sexual intercourse. Close monitoring and adherence to medical advice are essential.
Understanding the implications of placenta praevia and its relationship to c-sections can help expectant mothers make informed decisions and receive appropriate care throughout pregnancy and delivery.
Recognising the causes, risks, and precautions associated with placenta praevia, individuals can navigate this condition with awareness and proactive management for a safe and healthy pregnancy journey.
Written by: Midwife Laura