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Placenta previa - Treatment

Treatment:

Treatment depends on various factors:

  • How much bleeding you had
  • Where the fetus is developed enough to survive outside the uterus
  • How much of the placenta is covering the cervix
  • The position of the fetus
  • The number of previous births you have had
  • Whether you are in labor

Many times the placenta moves away from the cervical opening before delivery.

If the placenta is near the cervix or is covering a portion of it, you may need to reduce activities and stay on bed rest. Your doctor will order pelvic rest, which means no intercourse, no tampons, and no douching. Nothing should be placed in the vagina.

If there is bleeding, however, you will most likely be admitted to a hospital for careful monitoring.

If you have lost a lot of blood, blood transfusions may be given. You may receive medicines to prevent premature labor and help the pregnancy continue to at least 36 weeks. Beyond 36 weeks, delivery of the baby may be the best treatment.

If your blood type is Rh-negative, you will be given anti-D immunoglobulin injections.

Your health care providers will carefully weigh your risk of ongoing bleeding against the risk of an early delivery for your baby.

Women with placenta previa most likely need to deliver the baby by cesarean section. This helps prevent death to the mother and baby. An emergency cesarean may be done if the placenta actually covers the cervix and the bleeding is heavy or life threatening.

Expectations (prognosis):

Placenta previa is most often diagnosed before bleeding occurs. Careful monitoring of the mother and unborn baby can prevent many of the significant dangers.

The biggest risk is that severe bleeding will require your baby to be delivered early, before major organs, such as the lungs, have developed.

Most complications can be avoided by hospitalizing a mother who is having symptoms, and delivering by C-section.

Complications:

Risks to the mother include:

  • Death
  • Major bleeding (hemorrhage)
  • Shock

There is also an increased risk for infection, blood clots, and necessary blood transfusions.

Prematurity (infant is less than 36 weeks gestation) causes most infant deaths in cases of placenta previa. Fetal blood loss or hemorrhage may occur because the placenta separates from the wall of the uterus during labor. The fetus also can lose blood when the uterus is opened during a C-section delivery.

Calling your health care provider:

Call your health care provider if you have bleeding from the vagina at any point in your pregnancy. Placenta previa can be dangerous to both you and your baby.

  • Reviewed last on: 10/28/2008
  • Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 18.

Houry DE, Abbott JT. Acute complications of pregnancy. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 177.

Cunnigham FG, Leveno KL, Bloom SL, et al . Obstetrical hemorrhage. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 22nd ed. New York, NY; McGraw-Hill; 2005:chap 35.

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