When you get pregnant, an organ develops to house the growing baby. The placenta is the organ that provides oxygen and nutrients to the baby and also removes waste from the baby’s body. This placenta will attach to the uterine wall after conception, and the baby’s umbilical cord will develop from this. The placenta generally attaches to the front or the back of the uterus. In some pregnancies, it can attach to the lower part of the uterus, resulting in placenta previa.
When the placenta attaches to the lower part of the uterus, it is known as a low-lying placenta or placenta previa. As the placenta grows, it may cover the cervix. Placenta previa is classified into two types –
Major Placenta Previa – The placenta covers the entire cervix
Minor Placenta Previa – The placenta covers a part of the cervix or less than 2 cm away from the cervix
Though you can find your placenta’s position in the first-trimester scan, a low-lying placenta is usually spotted in the 20th-week ultrasound.
If the placenta grows upwards, there will be very little or no complication during delivery. However, if the placenta grows sideways, it can cover a part of or the entire cervix. It can also cover the baby’s path during the time of delivery, which is a complication.
Importance of Placenta Position
The placenta usually attaches to the top, side, front, or back of the uterus. The position of the placenta can impact your pregnancy in multiple ways. However, none of these positions are a reason for concern. Only a low-lying placenta can cause complications due to its position.
Anterior Placenta – The placenta attaches to the front uterine wall. This position can make it hard for the mother to feel the baby’s kicks. It can also be challenging to get clear images during an ultrasound.
Posterior Placenta – The placenta attaches to the back wall of the uterus, which is closer to the mother’s spine.
Lateral Placenta – The placenta attaches to one side of the uterine wall. The baby will get a uniform blood supply from one uterine artery and a reduced blood supply from the other artery. This position increases the risk of preeclampsia.
Fundal Placenta – The placenta attaches to the top part of the uterus. This position increases the risk of premature rupture of the membrane.
Low Lying Placenta – The placenta attaches to the lower part of the uterus and can grow over the cervical opening, thus blocking the baby’s path during delivery. This is the riskiest position for a placenta to implant.
No one has any control over where the placenta implants or attaches in the uterus. Family medical history and certain lifestyle habits can increase the risk of a low-lying placenta.
The following can increase your risk of a low-lying placenta:
Usage of cocaine or regular smoking
Above 35 years of age
Multiple pregnancies (carrying more than one baby)
History of uterine surgery like LSCS, myomectomy
Uterine fibroids
Pregnant in the past multiple times
Low Lying Placenta Symptoms
The placenta’s position is unknown until you take an ultrasound. A low-lying placenta can be uncomfortable. If your placenta is low-lying, you may experience the following symptoms.
You may notice bright blood from your vagina – usually around the second half of the pregnancy. The bleeding can be continuous or irregular.
Complications of a Low-Lying Placenta in Pregnancy
Low-lying placenta causes more complications than other placental positions. Some of the common complications a low-lying placenta can cause are:
Excess Bleeding – This is the most common complication of a low-lying placenta. The bleeding can happen anytime during pregnancy, labour, or even during delivery. Excess bleeding can lead to other complications.
Emergency Surgery – In case of excess bleeding during pregnancy, the doctor might opt for a C-section to save both the baby and the mother. This can happen before the baby reaches full term. So, it can lead to a preterm delivery.
Placenta Accreta – The low-lying placenta will grow deep into the uterine wall. It can lead to excess bleeding after the delivery.
Placental Abruption – The placenta will detach from the uterine wall before the delivery. When the placenta detaches, it loses the oxygen and nutrient supply from the mother’s body to the baby’s body. The baby will continue to receive oxygen and nutrients through the umbilical cord, but the supply will be low.
How to Care for a Low-Lying Placenta?
If your 20th-week ultrasound reveals a low-lying placenta, you need to be very careful as your pregnancy progresses. Here are a few tips to care for your low-lying placenta to ensure both mother and baby are safe throughout the pregnancy:
Avoid exercises that involve running, jumping, or lifting weights, as they will add pressure to the abdomen
Avoid penetrative sex and douching
Don’t use tampons if you are bleeding
Regular monitoring by the doctor – frequent scans to track the placenta’s growth and physical check-ups.
Complete or partial bed rest, depending on the severity of the placenta previa.
Conclusion
A low-lying placenta is a definite cause for concern. If your ultrasound reveals placenta previa, discuss your concerns with your doctor. A well-experienced gynaecologist associated with a well-equipped hospital can help you have a safe pregnancy and delivery.
FAQs
1. Does the placenta position change after 20 weeks?
The implantation position does not change. However, the placenta can continue to grow in any direction. The direction of growth can change the overall position of the placenta.
2. Can placenta previa go away after 20 weeks?
If the placental growth happens towards the fundus in the second half of pregnancy, placenta previa may not be there. As the pregnancy advanced the chances of placenta previa reduces.
3. Should I worry about a low-lying placenta in 18 weeks?
A low-lying placenta is always a cause for concern. However, if the placenta grows upwards instead of sideways, it will not cover the cervix. So, wait for your 20-week scan and consult your doctor before you start panicking.
4. What problems can the placenta cause at 20 weeks?
The placenta can be low-lying, detach itself from the uterine wall, grow deep into the uterine wall, or cause excess bleeding in the mother.
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