Placenta is placed in the cervix on the baby's birth tract is
called placenta previa. Normally the placenta is not located on the cervix, it
is located near the uterus or in the fundus above. The location of the placenta
can be clearly observed on ultrasound examination. The diagnosis of placenta
previa is made by ultrasound. It occurs at a rate of about 300 pregnancies.
The placenta can completely or partially close the cervix or
can only be located close to the cervix, accordingly there are 4 types:
Placenta
previa totalis: Placenta completely closed internal cervical os. This
is the most common type (40%).
- Partial
placenta previa: The placenta partially closed the internal os of the
cervix.
- Marginal
placenta previa: The placenta cervix is located on the edge of the
internal os, it has not closed the canal, but it can still cause bleeding.
-
Down-placenta (Low-lying placenta): The placenta has extended to the
lower uterine segment but is not above or bordered by the cervical os.
Who is seen
more often? Risk factors?
Advanced maternal age
- Multiparite
- Cigaret
- Multiple pregnancy (twins, triplets)
- Having had an abortion before
- Having had a cesarean before
- Having had a uterus surgery before
- Having a pre-placenta pregnancy before
- It is more common in male fetuses
- There are studies reporting that it is more common in
people living at high altitudes. (Due to the lack of oxygen, it expands the
surface area for compacting the placenta.)
The first finding is light red vaginal bleeding in the style
of spotting. This bleeding can also be severe. No bleeding in the uterus during
bleeding and the patient does not feel pain are characteristic findings for
placenta previa. However, sometimes there are pains in the form of labor pains.
In some cases, placenta previa causes early removal of the
placenta.
If the placenta previa bleeding occurred before the baby
matured and the amount of bleeding is low, the baby is allowed to mature. The
physical activity of the mother can also start bleeding from the placenta.
Therefore, the physical activity of the patient is restricted and taken to bed
rest.
Since sexual intercourse can also initiate bleeding, it is
prohibited in patients with placenta previal. During follow-up, delivery is
decided when the baby has completed maturation, or when vaginal bleeding has
reached serious proportions.
If bleeding is high enough to threaten mother's life and
baby, cesarean delivery is inevitable. Again, it is not necessary to wait in
hemorrhage, which is the term of pregnancy, and birth is carried out. Although
delivery is mostly by cesarean section, it is rarely possible to have normal
delivery in cases where the pleenta does not cover the cervix much and in cases
where there is little bleeding.
CASE PREVIA
Cord veins extending from the placenta to the baby normally
pass through amniotic fluid. In the case of vasa previa, the vessels show
branching on the amniotic membrane. This branching usually occurs at the level
of the cervix. These veins, which do not have a protective layer of Wharton gel
on them, easily rupture and bleed when the pouch is opened. Since the blood
lost is the blood of the fetus, it can lead to the development of fetal
distress and the death of the baby in a short time. Even if there is no bleeding,
these vessels cause fetal distress because they are sensitive to pressure.
Emergency bleeding is required when bleeding or fetal distress.
Vaza previa is more common in IVF pregnancies.
-UMBILICAL CORD AROUND BABY’S NECK
-LOW AMNIOTIC FLUID IN PREGNANCY
-HIGH AMNIOTIC FLUID IN PREGNANCY
-PREMATURE MEMBRANE RUPTURE
-FETAL DISTRESS
