Placenta Previa: Managing Bleeding in Pregnancy

20 weeks placenta previa

Doctor, I would like to ask about my situation.
During my first pregnancy, I experienced bleeding and had to induce labor after my water broke at 20 weeks.
Now, during my second pregnancy, I started having brownish bleeding at 19 weeks.
After visiting the obstetrics and gynecology clinic, the doctor prescribed medication to support the pregnancy and stop the bleeding, advising me to rest at home.
However, the situation did not improve, and the blood turned dark red.
I went back to the obstetrics and gynecology department, and the doctor recommended that I go to Chang Gung Memorial Hospital for further examination, stating that they have better facilities in case of premature labor.
I went to Chang Gung, but after reviewing the ultrasound, the doctor told me not to worry and to rest at home.
However, when I got home and wiped after using the bathroom, I noticed a large amount of dark red bleeding.
I quickly went to the emergency department of my original prenatal care hospital.
The nurse performed a cervical exam and said I was 1 cm dilated.
Previously, during a cervical exam, the doctor mentioned that since I had a previous delivery, my cervix might be slightly more open.
Later, the emergency doctor performed an ultrasound and directly told me that I had a placenta previa.
I was then hospitalized and put on bed rest.
On the third day of my hospitalization, the doctor helped clear the accumulated blood, and after that, there was no bleeding.
I was preparing to be discharged and had my IV medication dosage reduced, but that night, when I went to the bathroom, I wiped and saw a large amount of blood that was both dark and bright.
I am really scared.
What should I do?

Huang, 20~29 year old female. Ask Date: 2015/11/12

Dr. Lin Wenbin reply Obstetrics and Gynecology

You need to relax and take things a bit easier.
There are many situations that even doctors cannot predict.
A doctor's treatment is often a response to the situation at hand.
Just let go of your worries and learn to be more accepting—both of yourself and of the doctor.
This is the best approach.

Reply Date: 2015/11/12

More Info

It sounds like you are experiencing a very challenging and concerning situation during your pregnancy, particularly with the complications related to placenta previa and the bleeding you have described. Let’s break down your concerns and provide some guidance based on the information you’ve shared.

Understanding Placenta Previa
Placenta previa occurs when the placenta is positioned low in the uterus, covering or being very close to the cervix. This condition can lead to significant bleeding, especially as the pregnancy progresses and the cervix begins to thin and open in preparation for labor. The bleeding can vary in color and amount, and it can be alarming when it occurs.

Managing Bleeding in Pregnancy
1. Monitoring and Rest: It’s crucial to follow your doctor’s advice regarding rest and monitoring your symptoms. Bed rest is often recommended for women with placenta previa to minimize the risk of bleeding. Avoiding heavy lifting, strenuous activities, and sexual intercourse is also advised.

2. Recognizing Symptoms: You should be vigilant about any changes in your bleeding. If you experience heavy bleeding (soaking through a pad in an hour), severe abdominal pain, or any signs of labor (such as contractions), you should seek immediate medical attention.
3. Hospitalization: Given your history of bleeding and the diagnosis of placenta previa, hospitalization may be necessary for close monitoring. In the hospital, healthcare providers can provide interventions such as IV fluids, medications to manage bleeding, and possibly steroids to help mature the baby’s lungs if early delivery becomes necessary.

4. Follow-Up Care: Regular ultrasounds will be important to monitor the position of the placenta as your pregnancy progresses. In some cases, the placenta may move away from the cervix as the uterus expands, which can reduce the risks associated with placenta previa.

5. Emergency Preparedness: Since you have experienced significant bleeding, it’s wise to have a plan in place for emergencies. Know the quickest route to the hospital and have a bag packed for your hospital stay, just in case you need to go in quickly.

Emotional Support
Experiencing complications during pregnancy can be emotionally taxing. It’s important to communicate your feelings and concerns with your healthcare provider, who can offer reassurance and support. Additionally, consider reaching out to friends, family, or support groups for emotional support during this time.

Nutritional Considerations
While managing your condition, ensure you are eating a balanced diet rich in iron and vitamins to support your health and the health of your baby. Foods high in iron (like leafy greens, lean meats, and legumes) can help prevent anemia, especially if you are experiencing bleeding.

Conclusion
In summary, managing a pregnancy with placenta previa requires careful monitoring, rest, and open communication with your healthcare team. It’s essential to be aware of your body’s signals and to seek help when necessary. Your health and the health of your baby are the top priorities, and your medical team is there to support you through this challenging time. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider for personalized advice and reassurance.

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