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What Happens to the Baby During Placenta Previa?

21 June 2024

Placenta previa is a condition during pregnancy where the placenta partially or completely covers the cervix, posing risks to both the mother and the baby. This condition can lead to significant complications, including preterm birth and severe bleeding. Understanding the implications of placenta previa on the baby is crucial for expecting parents and healthcare providers to manage the condition effectively and ensure a healthy pregnancy outcome.

What is Placenta Previa?

Definition and Types

Placenta previa occurs when the placenta attaches to the lower part of the uterus, covering the cervix either partially or completely. It is classified into three types:

Types of Placenta Previa

Placenta previa is a pregnancy complication where the placenta partially or completely covers the cervix, which is the opening to the uterus. Understanding the different types of placenta previa is essential for managing the condition effectively and ensuring the health and safety of both the mother and baby. The classification is based on the location of the placenta in relation to the cervix. Here, we detail the various types of placenta previa and their implications.

Complete Placenta Previa

Definition: Complete placenta previa occurs when the placenta entirely covers the cervical opening. This is the most severe form of placenta previa and poses significant risks during pregnancy and delivery.

Implications:

Severe Bleeding: Complete coverage of the cervix increases the risk of heavy bleeding (hemorrhage) during pregnancy and labor. This bleeding can be life-threatening for both the mother and baby.
Cesarean Delivery: Vaginal delivery is not possible with complete placenta previa due to the high risk of bleeding and placental damage. A planned cesarean section (C-section) is usually scheduled before labor begins to ensure the safety of both mother and baby.

Partial Placenta Previa

Definition: Partial placenta previa is when the placenta partially covers the cervical opening. This type poses moderate risks and often requires careful monitoring throughout the pregnancy.

Marginal Placenta Previa

Definition: Marginal placenta previa occurs when the placenta is located at the edge of the cervix but does not cover it. This type is less severe and may resolve on its own as the pregnancy progresses.

Low-Lying Placenta

Definition: A low-lying placenta is when the placenta is implanted in the lower part of the uterus but is not close enough to the cervix to be classified as previa. This condition may be identified early in pregnancy and often resolves as the uterus expands.

Distinguishing Features and Management

Each type of placenta previa has distinct features and requires specific management strategies to ensure a safe pregnancy and delivery. Here are some key points for distinguishing and managing each type:

Complete Placenta Previa:

Features: Complete coverage of the cervix.
Management: Planned C-section, close monitoring, potential hospitalization for bleeding management.

Partial Placenta Previa:

Features: Partial coverage of the cervix.
Management: Regular ultrasounds, potential for cesarean delivery, possible vaginal delivery if placenta moves.

Marginal Placenta Previa:

Features: Placenta at the edge of the cervix.
Management: Monitoring, possible vaginal delivery, careful management of any bleeding.

Low-Lying Placenta:

Features: Placenta implanted in the lower uterus but not near the cervix.
Management: Regular ultrasounds, typically resolves on its own, vaginal delivery likely if placenta moves higher.

Monitoring and Treatment Approaches

Effective management of placenta previa involves regular prenatal care, careful monitoring, and timely intervention to address any complications. Here’s an overview of monitoring and treatment approaches for different types of placenta previa:

Prenatal Care:

Ultrasounds: Regular ultrasounds are essential to monitor the position of the placenta and check for any signs of movement or changes.
Non-Stress Tests (NST): To monitor the baby’s heart rate and ensure that the baby is receiving adequate oxygen and nutrients.
Biophysical Profiles (BPP): Combines ultrasound and NST to assess the baby’s overall health, including movements, muscle tone, and amniotic fluid levels.

Activity Restrictions:

Bed Rest: In some cases, partial or complete bed rest may be recommended to reduce the risk of bleeding and preterm labor.
Avoiding Strenuous Activities: Patients are advised to avoid heavy lifting, sexual intercourse, and activities that could trigger contractions or bleeding.

Hospitalization:

Severe Cases: In cases of significant bleeding or other complications, hospitalization may be necessary for closer monitoring and immediate medical intervention.

Delivery Planning:

Cesarean Section: Planned C-sections are usually scheduled for complete and partial placenta previa to avoid the risks associated with vaginal delivery.
Timing: The timing of the delivery is crucial to balance the risks of preterm birth with the dangers of continued pregnancy with placenta previa. Delivery is often planned around 36-37 weeks, or earlier if significant bleeding occurs.

Understanding the different types of placenta previa is essential for managing this condition effectively and ensuring the health and safety of both the mother and the baby. Each type has distinct implications and requires specific management strategies, from regular monitoring and activity restrictions to planned cesarean deliveries. With appropriate prenatal care and timely intervention, most women with placenta previa can have successful pregnancies and healthy babies.

Incidence and Risk Factors

Placenta previa is relatively rare, occurring in about 1 in 200 pregnancies. The condition is more common in women with certain risk factors, including:

Previous placenta previa
Multiple pregnancies (twins or more)
Advanced maternal age
Previous cesarean sections
Uterine surgery or scarring
Smoking

Placenta Previa and Its Impact on the Baby

Risks to the Baby

Placenta previa can have several potential impacts on the baby, mainly due to complications arising from the condition:

Preterm Birth: One of the most significant risks is preterm birth. Because placenta previa often causes bleeding, doctors may recommend an early delivery to ensure the safety of both mother and baby. Preterm infants may face challenges such as respiratory distress syndrome, developmental delays, and feeding difficulties.
Growth Restriction: Placenta previa may affect the baby’s growth if it impairs the placenta’s ability to provide adequate nutrients and oxygen. This can result in intrauterine growth restriction (IUGR), where the baby is smaller than expected for the gestational age.
Low Birth Weight: Babies born to mothers with placenta previa are at a higher risk of being born with low birth weight, often due to preterm birth and growth restrictions.

Management Strategies

Effective management of placenta previa is critical to minimize risks and ensure the best possible outcome for the baby. Strategies include:

Regular Monitoring: Frequent ultrasounds and prenatal visits help monitor the placenta’s position and the baby’s growth.
Activity Restrictions: Doctors often recommend bed rest or limited physical activity to reduce the risk of bleeding.
Corticosteroids: If preterm birth is likely, corticosteroids may be administered to help mature the baby’s lungs and reduce the risk of complications.
Planned Cesarean Delivery: In most cases, a cesarean section is planned around 36-37 weeks to minimize risks associated with labor and bleeding.

The Baby’s Development and Placenta Previa

Fetal Monitoring and Assessment

Regular fetal monitoring is essential in pregnancies complicated by placenta previa. This includes:

Non-Stress Tests (NST): To check the baby’s heart rate and response to movement.
Biophysical Profile (BPP): Combines an ultrasound with an NST to assess the baby’s health, including movements, muscle tone, and amniotic fluid levels.
Doppler Ultrasound: To evaluate blood flow in the umbilical artery and ensure the baby is receiving sufficient nutrients and oxygen.

Maternal-Fetal Medicine Specialists

High-risk pregnancies, such as those involving placenta previa, often require the expertise of maternal-fetal medicine (MFM) specialists. These doctors specialize in managing complex pregnancies and ensuring both maternal and fetal well-being.

Delivery Planning with Placenta Previa

Timing and Mode of Delivery

The timing and mode of delivery are crucial decisions in pregnancies complicated by placenta previa. The goal is to balance the risks of preterm birth with the dangers of prolonged pregnancy with placenta previa.

Planned Cesarean Section: Most women with placenta previa will have a planned cesarean section to avoid the risks of vaginal delivery. This is usually scheduled between 36-37 weeks, or earlier if significant bleeding occurs.
Emergency Delivery: In cases of severe bleeding or fetal distress, an emergency cesarean section may be necessary regardless of gestational age.

Neonatal Intensive Care

Preterm infants or those with complications due to placenta previa may require care in a neonatal intensive care unit (NICU). The NICU provides specialized care, including respiratory support, feeding assistance, and close monitoring of vital signs to ensure the baby’s health and development.

Emotional and Psychological Impact on Parents

Coping with Stress and Anxiety

Dealing with placenta previa can be highly stressful for expectant parents. Concerns about the baby’s health and the risks of preterm birth can lead to significant anxiety.

Support Systems

It is essential for parents to have strong support systems, including:

Counseling Services: Professional counseling can help manage anxiety and stress.
Support Groups: Connecting with other parents facing similar challenges can provide emotional support and practical advice.
Education and Information: Understanding placenta previa and its management can help parents feel more in control and prepared.

Long-Term Outcomes for Babies Born with Placenta Previa

Babies born to mothers with placenta previa can face various challenges, particularly if they are born preterm. However, advancements in neonatal care and early intervention strategies have significantly improved the prognosis for these infants. Understanding the potential long-term outcomes and the necessary follow-up care can help parents and healthcare providers support the healthy development of these children.

Overview of Potential Challenges

Babies born with placenta previa might experience several immediate and long-term challenges, primarily due to complications such as preterm birth, intrauterine growth restriction (IUGR), and low birth weight. The extent of these challenges often depends on the severity of the placenta previa and the timing of the delivery.

Preterm Birth and Its Consequences

Preterm birth, defined as birth before 37 weeks of gestation, is a common outcome in pregnancies complicated by placenta previa. They are at higher risk for several health issues, including:

Respiratory Distress Syndrome (RDS): Due to underdeveloped lungs, preterm babies often require respiratory support. Advances in neonatal care, including the use of surfactant therapy and mechanical ventilation, have significantly improved outcomes.
Neurodevelopmental Delays: Preterm infants are at increased risk for developmental delays, including motor skills, cognitive function, and behavioral challenges. Early intervention and regular developmental assessments can mitigate these risks.
Feeding Difficulties: Coordination of sucking, swallowing, and breathing can be challenging for preterm infants, necessitating specialized feeding support.

Long-Term Health and Developmental Monitoring

Continuous monitoring and support are crucial for children born preterm due to placenta previa. This includes:

Regular Pediatric Check-Ups: Frequent health check-ups to monitor growth, developmental milestones, and overall health.
Developmental Assessments: Early identification of any developmental delays through assessments by pediatricians and specialists.
Specialist Consultations: Depending on the child’s needs, consultations with neurologists, pulmonologists, and other specialists may be necessary.

Conclusion

Placenta previa presents significant challenges and risks to both the mother and the baby. However, with careful monitoring, appropriate management strategies, and timely intervention, the risks can be minimized, and positive outcomes can be achieved. Understanding the potential impacts on the baby and working closely with healthcare providers ensures that parents can navigate this complex condition with confidence and hope for a healthy pregnancy and delivery.

Our Doctors

Dedicated IR Center for Vascular Problems in Madhya Pradesh

DR. SHAILESH GUPTA
MD, PDCC (INTERVENTIONAL RADIOLOGY) Consultant & Co-Director CVIC (Center Of Vascular & Interventional Care)

DR. ALOK KUMAR UDIYA
MD Radiology, PDCC (Neurointervention Radiology), PDCC ( HPB Intervention Radiology) FINR (Switzerland) & EBIR
Endovascular Surgeon & Consultant Interventional Neuroradiologist at Care CHL Hospital, Indore Co-director CVIC( center for vascular and interventional care)

DR. NISHANT BHARGAVA
Consultant Intervention Radiologist
MD Radiology, PDCC ( Neurointervention Radiology), FINR ( Fellowship in Neurointervention Radiology)
Co-director CVIC(Center for Vascular and Interventional Care)