The fertilization of a woman’s egg by a man’s sperm occurs in the fallopian tubes which are the tubes that connect the ovaries to the uterus. The fertilized egg is initially called a zygote and, after fertilization, travels to the uterus. It attaches itself to the uterine wall, a process that takes about three to five days after fertilization. The inner cells of the zygote develop into the embryo and the outer cells become the placenta.
The placenta grows and at about five to seven weeks of gestation, the umbilical cord develops and provides the lifeline between the zygote, which is now a fetus, and the mother’s uterus. The normal place of attachment of the zygote is high up in the uterus or a little to the side and away from the cervix.
What is Placentia Previa
When the placenta attaches lower in the uterus near or covering the cervix, it is called placenta previa. There are three types:
- Marginal: The placenta attaches near the cervix, but does not cover it.
- Partial: The placenta attaches at a point in the uterus where it partially covers the cervix.
- Complete: The placenta covers the entire cervical opening.
The condition is often discovered in a routine ultrasound. If found early in the pregnancy, the mother will be closely monitored to see if the placenta moves itself up to the proper position. As the pregnancy progresses, the lower part of the uterus begins to thin in preparation for birth. If the placenta is partially or completely covering the cervix as it begins to thin, the cervix and placenta will bleed into the vagina. The bleeding may be slight or severe enough to be life-threatening.
Placenta Previa Symptoms
The main symptom of placenta previa is sudden bleeding from the vagina. The bleeding of placenta previa may be accompanied by cramps. It may resolve on its own, but usually begins again in a few days. Pregnant women who begin bleeding during pregnancy should immediately contact their health care provider no matter what trimester they are in when the bleeding begins.
How Placenta Previa is Diagnosed
If not diagnosed during a routine ultrasound early in the pregnancy, when a pregnant woman presents with vaginal bleeding, an ultrasound will be done.It may be necessary to a transvaginal ultrasound, which involves carefully inserting a device into the vagina. The device is like a wand and may be able to locate the position of the placenta when a regular ultrasound cannot. In some cases, a magnetic resonance imaging (MRI) test may be required.
Placenta Previa Risk Factors
Women of all ages may have a placenta previa pregnancy whether it is their first or twelfth pregnancy, but there are circumstances that increase the risk of having the condition such as:
- Having had previous uterine surgery that left scars in the lining.
- A large placenta which often occurs in multiple births.
- Pregnancy in women aged 35 or older.
- Previous pregnancies and live births.
- Previous Cesarean Section.
- Surgery for uterine fibroids.
- Previous dilatation and curettage (D and C procedure).
- Having had at least one previous pregnancy.
- Smoking or a history of smoking.
- Cocaine use.
- An abnormal or unusual shaped uterus.
- Multiple pregnancy.
- In vitro fertilization.
Treatment For Placenta Previa
Treatment varies depending on a number of factors:
- The stage of the pregnancy.
- The amount of bleeding that occurred or is occurring.
- Whether the bleeding is continuous, intermittent or stops on its own.
- The exact position of the placenta,
- Whether or not the placenta is completely or only partially covering the cervix.
- The overall health of the mother and the baby.
If the bleeding is heavy and the baby is viable, an emergency Cesarean section may be required. Otherwise, the woman may be required to remain on bed rest for the remainder of the pregnancy. Bed rest may be at home if there is a responsible person who can care for the mother. If not, hospitalization and bed rest may be required. In addition to bed rest, other treatment recommendations may include:
- No sex, douching or tampons.
- Blood transfusion.
- Prevention of early labor by use of medication in attempt to allow the pregnancy to go to at least 36 week’s gestation.
- For immature babies, use of steroids to help lung development.
Consequences of Failure to Diagnose or to Properly Monitor Placenta Previa
Women with this condition almost always need a Cesarean section, especially if the placenta partially or completely covers the cervix. Other consequences of failing to diagnose or improperly treat placenta previa include:
- Fetal growth delayed or slowed down.
- Birth defects.
- Life-threatening bleeding and even death of the mother and or baby during labor and delivery.
- Need for hysterectomy following birth if the bleeding cannot be stopped.
- Infection after delivery.
If you suffered from complications from undiagnosed or improperly treated placenta previa, contact our medical malpractice attorneys for a free consultation.