Is a low-lying placenta common?
The position of the placenta will be checked at the second trimester ultrasound, around 18 to 21 weeks of pregnancy. if your placenta is low-lying, you’ll have another scan later in your pregnancy (usually around 32 weeks).
Because the lower part of the womb stretches more as the baby grows, the placenta usually moves toward the top of the womb at this point. 90% of women who have a low-lying placenta at 20 weeks will not have a low-lying placenta later in pregnancy.
If you’ve had a baby by C-section before, the placenta is less likely to move up.
Only 1 in 200 women have placenta previa at the end of their pregnancy.
Is it likely that I have placenta previa?
placenta previa is more likely if you:
- smoking cigarettes
- have had fertility treatment to get pregnant, such as in vitro fertilization (IVF)
- have had 1 or more caesarean sections
- You are 40 years old or older
- are having more than 1 baby
- have had surgery on the uterus
- are cocaine users
- expecting a boy
- You have endometriosis.
- has bleeding during the second or third trimester; this is usually painless and can occur after sex
- if the baby is lying in an unusual position, for example, buttocks first (breech) or lying on the uterus (transverse)
- vaginal bleeding, including spotting
- contractions
- pain, including any vague period-like pain.
- You are at higher risk of having your baby early (less than 37 weeks).
- Your baby will need to be delivered by cesarean section because the placenta is blocking the birth canal.
Is there anything I can do to help the placenta come up?
Unfortunately not. the best thing you can do is focus on staying as healthy as possible. You may need additional tests, so be sure to keep all of your prenatal appointments and follow your healthcare professional’s advice.
How can placenta previa affect me and my baby?
There is a risk of vaginal bleeding, especially towards the end of your pregnancy. Bleeding from placenta previa can be very heavy and can sometimes put mother and baby at risk.
How is a low-lying placenta diagnosed?
Your midwife or doctor will look at the position of your placenta on your ultrasound at 18 to 21 weeks.
If your placenta is low-lying, you’ll be offered an additional ultrasound later in your pregnancy (usually around 32 weeks) to check its position again.
In 90% of cases, the placenta is no longer low-lying at this point.
Your midwife or doctor may think you have placenta previa if:
If you have any bleeding during pregnancy, with or without pain, you should always get it checked out right away. If you are in your first trimester, contact your doctor, midwife, or early pregnancy unit. If you are more than 12 weeks pregnant, go to your local a&e or contact your hospital’s maternity unit immediately.
You may be advised to avoid sexual intercourse (including the use of penetrative sex toys) for the remainder of your pregnancy.
what treatment will I have?
additional scans
if your placenta is low-lying at the 20 week ultrasound, you will be offered another ultrasound around week 32. this may include a transvaginal ultrasound, which is when a probe is gently placed inside the vagina to check exactly where the placenta is found. don’t worry, this is safe for you and your baby.
The length of your cervix can also be measured at your 32 week ultrasound to predict if you can go into labor early and if you are at increased risk of bleeding.
If the placenta has not moved upward, you should be offered another ultrasound at 36 weeks. The results of this scan will help you and your doctor plan the safest way to give birth.
medication
If you have placenta previa, there is a risk that you may give birth prematurely. therefore, you may be offered a course of steroid injections between 34 and 36 weeks of pregnancy to help your baby’s lungs mature further.
If you go into labor early, you may be offered medicine to try to stop your contractions. this will give you time to receive a course of steroid injections. if you have heavy bleeding or labor in progress, your baby may need to be delivered.
If you have vaginal bleeding, you may need to be hospitalized. this is because there is a small risk that you may bleed suddenly and heavily. If this happens, you may need an emergency C-section.
What should I do if I have a low-lying placenta?
If you know you have a low-lying placenta, you should contact the hospital immediately if you have:
If you have bleeding, your doctor may need to do an internal exam to check where it’s coming from. this is safe and they will ask your permission before starting.
anemia
Anemia is a blood condition that develops when you don’t have enough red blood cells. Red blood cells contain hemoglobin, a protein that carries oxygen throughout the body and to the baby.
If you have a low-lying placenta, it’s important to try to avoid developing anemia, which can be common during pregnancy. Eating a healthy, balanced diet will help prevent or control anemia. iron supplements may also help, if recommended by your health care team.
how will my baby be born?
Your health care team will talk with you about your options for giving birth.
You may be advised to deliver early if you have heavy bleeding before your due date.
If the edge of your placenta is very close (less than 20mm) to your cervix (entrance to the uterus), the Royal College of Obstetricians and Gynecologists states that the safest way to give birth is by Caesarean section. this will generally be between 36 and 37 weeks. Your doctor will discuss your options with you, but how you deliver is ultimately your decision. But if you’ve had vaginal bleeding during your pregnancy, you may be advised to have a C-section sooner.
If the placenta is more than 20 mm from your cervix, you may be able to have a vaginal birth if you want to.
If you’re having a C-section, a senior obstetrician (a doctor who specializes in pregnancy) will be there. this is because you may have heavy bleeding during surgery. if this happens, you may need a blood transfusion. this is more likely if you have placenta previa.
Talk to your doctor before surgery if, for any reason, you don’t want a blood transfusion.
Unfortunately, complications are more common with C-sections if you have a low-lying placenta. Your doctor should discuss the risks of major bleeding and hysterectomy (removal of the uterus) with you before your C-section. For most women, the risk of hysterectomy is low and will only occur as a last resort if other measures to control bleeding are not effective.
if you have placenta previa:
your mental health
The diagnosis of complications in pregnancy can be difficult. and being asked to watch for certain symptoms, such as bleeding, and the need for additional appointments and check-ups can cause anxiety and stress. it can also be a lonely experience when those around you don’t understand what it’s like.
Remember you can tell your midwife or doctor how you feel. they will do their best to put you at ease and answer any questions you may have.
You can also call our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm) or email us at [email protected]
If you’re having a hard time coping, professional support is available. don’t suffer in silence. tell your midwife or GP how you feel. they will help you access the support you need.
Learn more about taking care of our mental health during pregnancy.
