I began to have bleeding when I reached the sixth month of my pregnancy. Although it was very minimal and it usually stopped by itself, it was very disturbing because it was a constant reminder that there was something wrong with my pregnancy. After the first episode, my doctor confirmed the news. I had a condition called Placenta Previa, or a pregnancy complication in which the placenta grows in the lowest part of the womb.

Aside from giving me medications, I was ordered to be on strict bed rest. The thought that my baby’s life depended on my compliance along with following my doctor’s orders was not at all comforting. I envisioned and hoped for a healthy pregnancy, but at that point it was clear that I needed to do my part in ensuring that my pregnancy stays guarded.

What is placenta previa?

The placenta is an organ that develops during pregnancy and its primary functions are providing food and oxygen to the baby, as well as producing hormones to sustain the needs of pregnancy. Normally, the placenta is attached in the upper part of the uterus, and away from the cervix or the lower part of the uterus. A low-lying placenta is actually common during the first trimester of pregnancy, but as pregnancy progresses and the placenta remains low on the uterus, a woman and her unborn child are at risk for life-threatening complications. Placenta previa is divided into three forms marginal, partial or total, which aptly describes the proximity of the placenta to the cervical os or the cervical opening.

What are the causes?

The cause of placenta previa is not entirely clear, but smoking and cocaine use during pregnancy has been found to increase the risk. The risk of getting placenta previa also tends to increase among women aged 35 years old and above, and for women with a history of past surgeries of the uterus. Likewise, a woman with a history of placenta previa is also at risk of having it again during her succeeding pregnancies.  This condition may also occur for women with many previous pregnancies, or those with an abnormally shaped uterus or any abnormal formation of the placenta.

What are the symptoms?

A characteristic symptom of placenta previa is a sudden and painless vaginal bleeding that can either be light or heavy in amount. The bleeding associated with this complication occurs on the latter part of the second trimester or it can also be during the initial weeks of the last trimester of pregnancy. Bleeding may be associated with mild cramping or symptoms similar to that of early labor. There are instances when bleeding begins only after labor has started.

How is it diagnosed?

Placenta previa is diagnosed through an ultrasound exam. Sometimes a diagnosis is made only when the cause of a bleeding episode is being determined.

How is it treated?

Treatment will vary and it will mostly depend on the type, and symptoms such as the amount of bleeding and how the condition affects the mother and her unborn child. In the absence of bleeding, women with placenta previa are mostly advised to limit activities. A doctor may also require bed rest, with emphasis on the avoidance of sex, douching and the use of tampons. In the event of heavy bleeding, careful monitoring may be required in the hospital. Blood transfusions may also be ordered to replace blood loss. Anti-D immunoglobulin injections may be ordered for women who are Rh-negative.

Due to the risk of premature birth, doctors may also prescribe medications that can prevent early labor. This will help a woman reach the 36th week of pregnancy or the time when the baby has a best chance of surviving. But if heavy bleeding continues, the doctor may consider an early delivery. If an emergency cesarean section is already imminent, doctors usually order medications to improve the baby’s lung maturity. If bleeding remains uncontrolled, doctors may resort to an early delivery regardless of the viability of the baby.

What are the complications?

The most alarming feature of placenta previa is the risk of severe hemorrhage during labor, delivery or even a few hours postpartum. The bleeding can even lead to maternal shock or death. Preterm delivery is also very common, so problems related to prematurity are common.

I had an emergency cesarean section on my 37th week of pregnancy. Thankfully, my daughter was already mature enough to breathe on her own. Although I spent almost half of my pregnancy on bed rest, I am still very fortunate that my daughter and I survived a high-risk pregnancy.