Pregnancy is a time of excitement and anticipation, but it can also bring unexpected complications. One such condition is placenta praevia, a term that might sound intimidating but is important to understand. While it’s not extremely common, placenta praevia can significantly impact your pregnancy, delivery, and health, making early diagnosis and proper care essential.
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In this guide, we’ll break down everything you need to know about placenta praevia, including its causes, warning signs, treatment options, and potential risks, so you can feel informed and empowered throughout your pregnancy.
What Is Placenta Praevia?
Placenta praevia occurs when the placenta lies unusually low in the uterus, either partially or completely covering the cervix (the opening to the birth canal). This placement can interfere with a safe vaginal delivery, as the placenta blocks the baby’s exit path.
There are three main types:
- Complete placenta praevia – the placenta fully covers the cervix.
- Partial placenta praevia – the placenta partially covers the cervix.
- Marginal placenta praevia – the edge of the placenta touches or is near the cervix.
It’s typically diagnosed during a routine ultrasound, often around the 18–20-week anatomy scan. In some cases, the placenta “moves up” as the uterus grows, resolving the issue by the third trimester. In others, it persists and requires careful monitoring and planning.
How Common Is Placenta Praevia?
Placenta praevia affects about 1 in 200 pregnancies in the third trimester. It’s more commonly seen in:
- Women who’ve had previous cesarean deliveries or uterine surgeries
- Pregnancies with multiple babies (twins, triplets, etc.)
- Women over age 35
- Those with a history of placenta praevia in a previous pregnancy
- Smokers
While it can happen without any risk factors, knowing your personal history can help your care provider monitor you more closely.
What Causes Placenta Praevia?
There’s no single known cause, but it’s believed to result from how and where the embryo implants in the uterus. If implantation occurs in the lower part of the uterus, the placenta can grow downward, rather than toward the top or side where it typically belongs.
Certain conditions may increase the likelihood, including:
- Scarring from past surgeries (like C-sections or D&Cs)
- Large placenta size
- Abnormal uterus shape or fibroids
Again, it’s not something you caused or could have prevented; it’s a structural issue, not a behavioural one.
Symptoms: What Are the Signs of Placenta Praevia?
The most common and important symptom of placenta praevia is painless vaginal bleeding, particularly in the second or third trimester. The bleeding may range from light spotting to heavy bleeding that requires urgent medical attention.
Other possible signs include:
- Preterm contractions
- Bleeding after sex
- Breech or transverse baby position (baby lying sideways or feet first)
Important: Not all vaginal bleeding during pregnancy is due to placenta praevia, but it should always be evaluated immediately. If you notice bright red bleeding, especially without pain, contact your doctor or go to the hospital right away.
Diagnosis: How Is It Detected?
Placenta praevia is usually diagnosed during a routine ultrasound, either abdominal or transvaginal. A transvaginal scan may be recommended if there’s concern about low placenta placement, as it gives a clearer view of the cervix and placenta position.
If you’re diagnosed with placenta praevia early in pregnancy, it may still resolve on its own. This is known as placental migration, and it happens as the uterus expands and pulls the placenta upward. Most cases diagnosed before 20 weeks correct themselves by the third trimester.
Treatment and Management
Management of placenta praevia depends on how far along you are in your pregnancy, the extent of the placenta’s coverage, and whether or not you’re experiencing bleeding.
If you have no symptoms:
- You’ll likely be monitored with regular ultrasounds to track the placenta’s position.
- Activity may be modified (e.g., avoiding heavy lifting, strenuous exercise, or sex).
- You may be advised to avoid vaginal exams to prevent disturbing the placenta.
If you have bleeding or other symptoms:
- Hospitalisation may be necessary for monitoring.
- You might receive corticosteroid injections to help your baby’s lungs mature in case early delivery is needed.
- Blood transfusions may be prepared if bleeding is severe.
Delivery Planning:
If placenta praevia persists into the third trimester and covers the cervix, a planned C-section is typically scheduled around 36–37 weeks, before labour starts naturally. Vaginal birth is usually not safe if the placenta is obstructing the cervix, as it can lead to heavy bleeding and risk to both mum and baby.
Risks and Complications
Placenta praevia, while manageable, can lead to serious complications if not properly monitored. Risks include:
- Severe bleeding (hemorrhage) during labour or delivery
- Preterm birth, especially if early delivery is required
- Placenta accreta, a rare condition where the placenta attaches too deeply into the uterine wall
- Increased risk of infection if the bleeding is prolonged
That said, with proper prenatal care and planning, most women with placenta praevia go on to have healthy pregnancies and babies. The key is early detection and careful management.
Emotional Impact: It’s Okay to Feel Overwhelmed
A placenta praevia diagnosis can bring feelings of fear, disappointment, or anxiety, especially if it limits your activity or changes your birth plan. You may grieve the idea of a vaginal delivery or feel nervous about a cesarean. These emotions are valid.
Talk openly with your healthcare provider about your concerns and ask questions. Knowing the facts can ease uncertainty, and being involved in your care plan helps you feel more in control.
You may also benefit from:
- Prenatal counselling
- Online or local support groups
- Talking to friends or other mums who’ve had similar experiences
You’re not alone; many parents have faced placenta praevia and come through it with healthy babies and positive outcomes.
When to Seek Immediate Help
If you have placenta praevia (or even if you don’t), it’s important to know when to go to the hospital:
- Bright red bleeding, even if painless
- Bleeding after sex or pelvic exams
- Cramping or contractions before 37 weeks
- Sudden decrease in the baby’s movements
- Signs of shock: dizziness, rapid heartbeat, or fainting
Never hesitate to seek emergency care. Bleeding in pregnancy should always be taken seriously.
Final Thoughts: Knowledge Is Power
Placenta praevia can sound scary, but with today’s medical care, most cases are manageable and have excellent outcomes. The most important things are early diagnosis, regular monitoring, and clear communication with your healthcare team.
Remember, every pregnancy is different. Whether you end up with a natural birth, a C-section, or something in between, the ultimate goal is the same: a safe delivery for both you and your baby.
If you’re dealing with a placenta praevia diagnosis or concerned about symptoms, don’t stay silent talk to your provider, ask questions, and reach out for support. You’ve got this, and you’re not alone.
