Placenta Previa: Complete vs. Marginal Cases Explained

Placenta previa? Marginal placenta previa?

Hello, I would like to ask a question.
Currently, I am 29 weeks pregnant with my first child.
At 25 weeks, the doctor informed me that I have a placenta previa issue.
At 27 weeks, the doctor diagnosed me with complete placenta previa and told me that the chance of vaginal delivery is very unlikely, and I need to choose an earlier date for a cesarean section.
Since the doctor did not explain further and it was quite sudden, I went to another hospital for a check-up, and the results indicated marginal placenta previa, explaining that it only covers a small area, so the chance of vaginal delivery is greater.
I am unsure how to handle this situation.
From a doctor's perspective, should I honestly explain my concerns and request further examination, or should I consider switching doctors? Thank you!

Niming, 30~39 year old female. Ask Date: 2017/07/31

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I am currently 29 weeks pregnant with my first child.
At 25 weeks, my doctor informed me that I have a placenta previa issue.
At 27 weeks, the doctor diagnosed me with complete placenta previa, stating that the chance of a vaginal delivery is very unlikely, and advised me to choose an earlier date for a cesarean section.
Since the doctor did not provide further explanation and it felt too sudden, I sought a second opinion at another hospital.
The results indicated marginal placenta previa, and they explained that it only covers a small area, which increases the likelihood of a vaginal delivery.
I am unsure how to handle this situation.
From a doctor's perspective, should I be honest and request further examinations, or should I consider switching doctors early? Answer: It may be better to switch doctors.

Reply Date: 2017/07/31

More Info

Understanding placenta previa is crucial for managing pregnancy, especially when complications arise. Placenta previa occurs when the placenta is abnormally positioned in the lower part of the uterus, covering the cervix either partially or completely. There are two primary classifications: complete (or total) placenta previa and marginal placenta previa.

Complete Placenta Previa: In this condition, the placenta entirely covers the cervical opening. This situation poses significant risks during labor, as it can lead to severe bleeding for both the mother and the baby. If a woman with complete placenta previa attempts a vaginal delivery, it can result in life-threatening complications. Therefore, a cesarean section is typically recommended, often scheduled before the onset of labor to minimize risks.

Marginal Placenta Previa: In contrast, marginal placenta previa occurs when the placenta is located at the edge of the cervix but does not cover it. This condition can sometimes resolve as the pregnancy progresses, with the placenta moving away from the cervix as the uterus expands. In many cases, women with marginal placenta previa may be able to have a vaginal delivery, but careful monitoring is essential.

In your situation, it appears that there was a change in diagnosis from complete to marginal placenta previa after seeking a second opinion. This discrepancy can occur due to various factors, including the position of the fetus, the angle of the ultrasound, or the timing of the examination. It is essential to have regular follow-ups with your healthcare provider to monitor the placenta's position as your pregnancy progresses.

Regarding your concerns about how to proceed, communication with your healthcare provider is key. If you feel uncertain about the diagnosis or the management plan, it is entirely reasonable to seek further clarification. You might consider asking your doctor for a detailed explanation of the differences between complete and marginal placenta previa, the implications for your delivery, and the rationale behind their recommendations. If you continue to feel uncomfortable or if your concerns are not adequately addressed, seeking a second opinion from another qualified obstetrician can be beneficial.

It is also important to consider the emotional aspect of this situation. Pregnancy can be a time filled with anxiety, especially when faced with potential complications. Ensure you have a support system in place, whether through family, friends, or support groups, to help you navigate these challenges.

In summary, the management of placenta previa depends on its classification and the associated risks. Regular monitoring and open communication with your healthcare provider are essential. If you feel your concerns are not being addressed, seeking a second opinion is a valid option. Your health and the health of your baby are paramount, and you deserve to feel confident in your care plan.

Similar Q&A

Managing Placenta Previa: Insights for Expecting Mothers

The patient, Chen Guanting, is 35 years old and is 7 months pregnant. Recently, she experienced bleeding and was subsequently hospitalized, where she was diagnosed with placenta previa. However, she is unsure about the reasons for this condition and seeks clarification from Dr. Z...

Dr. Zhong Wenzhen reply Obstetrics and Gynecology
Placenta previa is a condition where the placenta implants at or near the cervical opening. Normally, after fertilization, the growing placenta is typically located at the fundus or on the anterior, posterior, or lateral walls of the uterus. However, in the case of placenta previ...

Understanding Partial Placenta Previa: Risks and Outcomes for Expecting Mothers

Hello Dr. Zheng, my wife is currently pregnant with our first child and is about 20.5 weeks along. During the recent ultrasound examination, the doctor mentioned that there is a partial placenta previa, where part of the placenta is covering the cervix. However, he said that many...

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: Placenta previa is generally diagnosed after 28 weeks of gestation. You may have a low-lying placenta, which requires monitoring after 28 weeks of pregnancy. If it is confirmed as placenta previa, you should avoid actions that increase abdominal pressure, such as squatting...

Understanding Placenta Previa: Symptoms and Concerns During Pregnancy

Hello, doctor! I am 5 months pregnant! Since I was 3 months along, I have been experiencing a feeling of bloating and hardness in my upper abdomen. I have sought medical attention, but this issue has not improved! Additionally, I have noticed some bleeding. Thank you!

Dr. Wu Zongcheng reply Obstetrics and Gynecology
Dr. Wu Zongcheng, the Director of the Department of Obstetrics and Gynecology at Tainan Hospital, responded that if there is bleeding during pregnancy, an ultrasound examination is necessary to accurately diagnose the cause. Placenta previa can be classified into (1) complete pla...

Understanding Complete Placenta Previa: Risks and Delivery Options

Hello, I am currently 24 weeks and 5 days pregnant with my third child. The fetus is healthy and has grown to 26 weeks. My first two pregnancies were natural and full-term. However, I have been diagnosed with complete placenta previa this time. The hospital and obstetricians have...

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: The placenta may have the opportunity to move upward as the pregnancy progresses, but this is not guaranteed. Therefore, if the placenta remains low and obstructs the pathway for natural delivery by the time of full term, it is referred to as placenta previa, which necessi...