Partial Placenta Previa: Risks and Outcomes for Expecting Mothers

Q: Partial Placenta Previa: Risks and Outcomes for Expecting Mothers

Hello： Placenta previa is generally diagnosed after 28 weeks of gestation. <br>You may have a low-lying placenta, which requires monitoring after 28 weeks of pregnancy. <br>If it is confirmed as placenta previa, you should avoid actions that increase abdominal pressure, such as s

Placenta previa

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 cases like this tend to resolve as the uterus grows.
If the partial placenta previa persists, many women start experiencing bleeding around 26-28 weeks, and there is a possibility of losing the baby.
I would like to ask how likely it is for the condition to resolve? If the partial placenta previa continues, what are the chances of preterm birth or losing the baby, and what are the associated risks for the mother, as well as the likelihood of those risks occurring?

kevin, 30~39 year old female. Ask Date: 2004/01/12

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 or bending over, and refrain from wearing high heels or tight clothing, as this can reduce the risk of bleeding.
If there is significant bleeding, an immediate cesarean section will be necessary to protect the mother.
The likelihood of a low-lying placenta returning to normal and the risk of bleeding cannot be assessed.
Dr.
Cheng Jin-He, Department of Obstetrics and Gynecology, Hsinchu City Hospital.

Reply Date: 2004/01/12

More Info

Partial placenta previa is a condition where the placenta partially covers the cervix, which can pose risks for both the mother and the fetus during pregnancy. Understanding the implications of this condition is crucial for managing the pregnancy effectively and ensuring the best possible outcomes.

In your case, at 20.5 weeks of gestation, it is not uncommon for healthcare providers to observe a partial placenta previa. As the uterus expands, many cases of placenta previa resolve on their own, with the placenta moving away from the cervix as the pregnancy progresses. Studies indicate that approximately 90% of women diagnosed with placenta previa in the second trimester will see resolution by the third trimester. However, the likelihood of resolution can depend on several factors, including the location of the placenta and the overall health of the pregnancy.

If the partial placenta previa persists into the later stages of pregnancy, particularly around 26 to 28 weeks, there is an increased risk of complications. One of the most significant concerns is the potential for vaginal bleeding, which can occur as the cervix begins to efface and dilate in preparation for labor. This bleeding can range from light spotting to heavy hemorrhage, which can pose risks to both the mother and the fetus. In severe cases, significant bleeding may necessitate an emergency cesarean section to protect the health of the mother and baby.

Regarding the risk of preterm birth, if the placenta continues to cover the cervix, the chances of preterm labor increase. The exact probability can vary, but studies suggest that women with placenta previa are at a higher risk for preterm delivery, particularly if they experience bleeding episodes. The management of such cases often involves close monitoring, and in some instances, hospitalization may be required to manage bleeding and ensure the safety of both the mother and the fetus.

From a maternal perspective, the risks associated with partial placenta previa include the potential for severe bleeding, which can lead to complications such as anemia or the need for blood transfusions. Additionally, if a cesarean delivery is required due to persistent previa, there are inherent risks associated with surgical procedures, including infection, blood loss, and complications from anesthesia.

To summarize, while many cases of partial placenta previa resolve as the pregnancy progresses, ongoing monitoring is essential. If the condition persists, there is an increased risk of bleeding and preterm birth, which can impact both maternal and fetal health. It is crucial to maintain open communication with your healthcare provider, who can offer personalized advice based on the specifics of your situation. Regular ultrasounds and follow-up appointments will help assess the position of the placenta and guide management decisions throughout the pregnancy.

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