Placental Abdomen: What is Placenta Previa and What Can I Do?

Placenta previa occurs in about 1 in 200 pregnant women. It describes an incorrect position of the placenta : the placenta lies in front of the cervix . If this is the case, the pregnancy will definitely be monitored more closely. Most pregnancies go smoothly. Only a spontaneous birth is excluded: the child is delivered by caesarean section . There are four different forms of placenta previa.

Four forms of placenta previa

• Low-lying placenta : Portions of the placenta reach close to the internal os.
• Placenta previa marginalis : The inner cervical os is only reached by placental tissue at the edge.
• Placenta previa partialis : The internal cervical os is only partially covered by placental tissue.
• Placenta previa totalis : The internal os of the cervix is ​​completely covered by a thick layer of placental tissue.

Illustration of a placenta previa

Causes of placenta previa

The causes of placenta previa have not yet been clearly clarified. However, it was observed more frequently in:

• previous cesarean sections,
• previous miscarriages ,
• previous manual placenta detachment (is necessary if the placenta did not detach by itself after a previous birth and had to be surgically removed from the uterus),
• previous excavations ,
• several previous births.

Diagnosis of placenta previa

Your doctor can diagnose you with placenta previa during your usual and regular ultrasound scans. If you are bleeding from the vagina during the second half of pregnancy, this can also be a sign of a misplaced placenta. It is therefore advisable to contact your doctor immediately in the event of bleeding. However, most pregnancies proceed without problems, because the baby continues to be well cared for regardless of the position of the placenta. Unfortunately, a natural birth is often impossible. The child will usually be born by caesarean section.

Procedure for placenta previa

The further procedure after the finding “placenta previa” depends on the extent of the placental disorders. If bleeding occurs, a cesarean section is performed in a mature child. If the child is still too young, the caesarean section should be postponed, because every day counts in the child’s maturing process. However, if the bleeding becomes too heavy, the doctor weighs up the risks and opportunities and can also recommend an earlier intervention. The surgical method chosen for a caesarean section also depends on the position of the placenta and its relation to the uterine wall:

• Placenta previa mainly on the posterior wall without growing into the uterine wall: A routine caesarean section is performed under local anesthesia.
• Placenta previa mainly on the front wall without growing into the wall of the uterus: The child is delivered with a routine caesarean section. The placenta is spared as much as possible.
• Placenta previa growing into the wall of the uterus : If the placenta detaches, there is an increased risk of bleeding. It is therefore important to have detailed advice about the procedure before the birth. Depending on whether you want to have more children, the doctor decides on a case-by-case basis how the placenta previa can best be treated without exposing mother and child to unnecessary risks.
• If the placenta detaches prematurely , this almost always requires a rapid delivery by caesarean section. In the case of small detachments that do not cause any significant symptoms in the pregnant woman, you can wait for a while.