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Placenta praevia: when the placenta covers the cervix
The placenta is the key organ that connects mother and baby during pregnancy, filtering maternal blood delivered to the fetus. In less than 5% of pregnancies, sometimes the placenta fits too low in the uterus. We call this placenta abnormality a cake preliminary. ” Placenta previa is a placenta inserted on a lower part of the uterus called the lower segment. », Explains Dr Frédéric Sabban, obstetrician-gynecologist. ” This placenta then completely or partially covers the cervix. »
Preliminary placenta : des causes diverses
Regarding the causes that may explain this configuration, we find in particular the shape of the uterus, the presence of possible fibroids preventing a higher implantation of the placenta, or smoking. Age is also a risk factor: women over 35 are more affected than others. The risk also increases with multiple pregnancies. Also, as with placenta accreta, having undergone curettage, cesarean section or other type of uterine surgery that causes scarring can lead to low placental insertion. But all the women having this placental pathology do not necessarily have a scarred uterus.
Diagnosis and precautions of placenta praevia
Most often, a placenta previa is detected by ultrasound, in the first trimester of pregnancy, “ because the patient presents unexplained bleeding », Explains Dr Sabban. ” This anomaly often leads to prescribing a very early stoppage of work and strict rest, in order to avoid any contraction. »Indeed, having contractions can increase bleeding, with a risk of bleeding that can lead to premature delivery. A period of rest is therefore strongly recommended, as well as a stop of sexual intercourse and intense physical activities.
In addition to these precautions, close monitoring by ultrasound can be set up from the third trimester, to see how this placenta evolves.
Placenta previa: is a cesarean necessarily necessary?
When the term approaches, and since there is no treatment for placenta previa, the medical team will need to decide what to do next. Indeed, a placenta praevia covering, that is, which completely covers the cervix, will result in an obligatory cesarean section, otherwise the risk of bleeding during delivery is greater. However, the placenta can be made to move slightly during pregnancy. ” It can for example be covering during the first trimester, then go up during pregnancy », Reassures Dr Sabban. Also, if the placenta is located 3 or 4 centimeters from the cervix, a vaginal birth is quite possible. Only the final position of the placenta before childbirth will decide the method chosen to deliver the baby.