Placenta Previa: Risks and Concerns in IVF Pregnancies

Placenta previa

Doctor, my wife is 44 years old and is currently 12 weeks pregnant with her second IVF pregnancy.
The doctor informed us that the placenta is positioned lower, close to the cervix.
Could this lead to what is known as placenta previa?

Gan'en, 40~49 year old female. Ask Date: 2021/10/31

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, continuous monitoring is required during prenatal check-ups, and you will only know at 6 to 7 months.
Wishing you good health.

Reply Date: 2021/10/31

More Info

Placenta previa is a condition where the placenta is located low in the uterus, covering or being very close to the cervix. This condition can pose significant risks during pregnancy, particularly during labor and delivery. In your wife's case, being 44 years old and pregnant through in vitro fertilization (IVF) adds additional considerations to her pregnancy.

Firstly, it is important to understand that placenta previa can be classified into different types based on how much of the cervix is covered by the placenta. If the placenta is merely low-lying but not covering the cervix, it may resolve as the pregnancy progresses and the uterus expands. However, if the placenta is covering the cervix, it can lead to complications such as bleeding, preterm birth, and the need for a cesarean section.

The risks associated with placenta previa include:
1. Bleeding: One of the most significant risks is bleeding, especially in the third trimester. This can be dangerous for both the mother and the baby. If bleeding occurs, it may necessitate hospitalization and close monitoring.

2. Preterm Birth: If the placenta previa is severe, it may lead to preterm labor. In some cases, doctors may recommend delivering the baby early to prevent complications.

3. Cesarean Delivery: If the placenta is covering the cervix at the time of delivery, a cesarean section will likely be necessary. This is to avoid complications that can arise from vaginal delivery, such as severe bleeding.

4. Increased Monitoring: Women with placenta previa often require more frequent ultrasounds and check-ups to monitor the position of the placenta and the health of the baby.

Given your wife's age and the fact that she is undergoing her second IVF pregnancy, it is crucial to maintain open communication with her healthcare provider. They will likely recommend regular ultrasounds to monitor the position of the placenta as the pregnancy progresses. In many cases, the placenta may move away from the cervix as the uterus grows, which can resolve the issue.

In terms of management, your wife's doctor may advise her to avoid activities that could increase the risk of bleeding, such as heavy lifting or vigorous exercise. It is also essential to report any signs of bleeding or unusual symptoms immediately.

Additionally, it is worth noting that advanced maternal age can increase the risk of certain complications during pregnancy, including chromosomal abnormalities and gestational diabetes. Therefore, it is vital for your wife to receive comprehensive prenatal care throughout her pregnancy.

In conclusion, while the presence of a low-lying placenta does raise concerns about placenta previa, many women with this condition go on to have healthy pregnancies and deliveries. Continuous monitoring and following the advice of her healthcare provider will be key in managing the risks associated with this condition. If you have further questions or concerns, do not hesitate to reach out to her healthcare team for personalized guidance and support.

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