Placenta Previaby Ann Butenas
It is the job of the placenta to provide the growing fetus with the necessary nutrients and oxygen. If this organ fails to function properly, the fetus could be deprived of oxygen and become malnourished. If a problem with the placenta is discovered early enough, doctors can work to maintain the health of the baby.
According to Dr. Stefan Semchyshyn, in his book, How to Prevent Miscarriage and Other Crisis of Pregnancy, "in a normal pregnancy, the fertilized ovum should implant on the upper portion of the uterus or womb, which is thicker, stronger, and more muscular than the lower half. However, in cases of placenta previa, the ovum implants on the weaker, lower portion of the womb, causing the placenta to grow over all or part of the cervical canal or cervical os. Complete or central placenta previa refers to a condition in which the cervical canal is completely covered. Partial or low-lying placenta previa means the cervical canal is only partially covered."
When the placenta grows and increases in weight, the weaker part of the uterus cannot offer sufficient support. This can cause the placenta to stretch and thin out, and could possibly tear and bleed.
"Painless bleeding," according to Dr. Semchyshyn, "in either the second or third trimester, is the only symptom of this potentially life-threatening situation for both mother and baby."
To confirm this condition, the patient should be given an ultrasound. If this problem has occurred, the ultrasound will show a bulge over the mouth of the womb. Serious internal bleeding can happen if the cervix is completely covered by the placenta and the mother is allowed to go into labor. Such cases usually call for a cesarean section delivery.
As for treatment for placenta previa, Dr. Semchyshyn notes that it all depends on the stage of the pregnancy in which the woman is in and the exact location of the placenta. If this occurs late in pregnancy, with complete covering of the cervical canal by the placenta, the doctor must decide if the pregnancy should be sustained or if a cesarean section should be performed. If tests show the baby's lungs can fully function outside of the womb, the doctor may proceed to go ahead with the delivery.
If placenta previa is noted in early months, before the baby can survive outside the mother, the doctor has to determine whether he can prolong the pregnancy without posing a risk to the mother. If the doctor feels this can be done safely, the mother will be instructed to bed rest. In addition, certain medication must be given to stop any uterine activity that could prompt premature labor. In these cases, the expectant mother must carefully monitor herself and alert her physician if she suspects any uterine activity.
If the medication helps to control the bleeding, the mother may be able to return to some of her normal activities until the birth of the baby. In some cases of partial previa, the growth of the baby forces the placenta upwards, away from the cervical canal.
Dr. Semchyshyn stresses that while placenta previa is a serious condition, with the aid of proper management, women can have a good chance of delivering a healthy baby.
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References for this article: Semchyshyn, Stefan, M.D., 1989. How to Prevent Miscarriage and Other Crisis of Pregnancy. New York: MacMillan Publishing Company.
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