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Placenta Previa
WHAT YOU SHOULD
KNOW
The placenta---the tissue that links mother and baby,
supplying food and taking away waste---is usually found near
the top of the uterus (womb). If it rests near the bottom, it
may block the birth canal, creating a serious problem for both
mother and child. This situation is known as placenta previa
(PREE-vee-uh), literally "placenta first."
Causes
We do not know what causes this problem. It's more likely
in women who have had 5 or more pregnancies, have scar tissue
in the uterus, or have had an earlier cesarean section. It also
happens more frequently in women over 35, those who have had an
abortion, and those who smoke.
Signs/Symptoms
The usual tip-off is sudden, painless, vaginal bleeding,
typically beginning in the 29th or 30th weeks. The bleeding can
be intermittent or constant, or a single gush of blood. If the
placenta is totally blocking the birth canal, the bleeding may
start earlier in the pregnancy.
Care
Your doctor will probably do an ultrasound examination;
and you may have to be hospitalized for other tests and
treatment. If the placenta is totally blocking the birth canal,
you will need a cesarean section, which is typically done after
the 36th week of pregnancy. If the birth canal is only partly
blocked, a vaginal delivery may be
possible.
Risks
This is a very dangerous---possibly fatal---situation.
You should seek care immediately.
WHAT YOU SHOULD
DO
-
Do not take any medicine without asking your
doctor.
-
Your doctor will tell you
whether you can pursue your normal activities or have to
stay in bed. If you're confined to bed, you may or may not
be allowed to get up to go to the bathroom.
-
Do not have sex until your
doctor says it's OK.
Call Your Doctor
If...
-
You are spotting blood from
the vagina.
-
The baby doesn't seem to be
moving as much as usual.
Seek Care Immediately
If...
-
You have vaginal bleeding
(more than just a spot or two).
IF YOU'RE HEADING FOR THE
HOSPITAL...
What to Expect While You're
There
You may encounter the following procedures and equipment
during your stay.
-
Taking Vital Signs: These include your temperature,
blood pressure, pulse (counting your heartbeats), and
respirations (counting your breaths). A stethoscope is used
to listen to your heart and lungs. Your blood pressure is
taken by wrapping a cuff around your arm.
-
Activity: You will need to stay in bed to help stop
the bleeding. The doctor will tell you when it's OK to get
up.
-
IV: A tube placed in your vein for giving medicine
or liquids. The IV will be capped or connected to tubing
and liquid.
-
Blood Tests: You may have blood taken for tests. It
can be drawn from a vein in your hand or from the bend in
your elbow. Several samples may be needed.
-
Blood Transfusion: If you've lost a lot of blood,
you may need a transfusion. Although you might be worried
about catching AIDS or hepatitis from a transfusion, the
actual risk is about 1 in a million. Blood loss is
therefore usually more dangerous than any risk a
transfusion may pose. Severe lack of blood could bring on a
heart attack.
-
Oxygen: At times during your stay, your body may
need extra oxygen. It is given either through a plastic
mask over your mouth and nose or through nasal prongs. If
the oxygen dries out your nose or the nasal prongs bother
you, tell your nurse, but don't take off the oxygen on your
own.
-
Ultrasound: This painless test uses sound waves to
look at different parts of your body such as your liver,
kidneys, uterus (womb), gallbladder, or other organs.
Pictures of these organs show up on a TV-like
screen.
-
MRI: To help locate the exact position of the
placenta, your doctor may order an MRI (Magnetic Resonance
Image). This machine can supply 3-D pictures of the
uterus.
-
Fetal Heart Monitoring: A loose fitting belt may be
placed around your abdomen to measure your baby's heart
rate. The belt holds a small metal disc attached to a
machine with a TV-like screen that shows a tracing of the
baby's heartbeat.
-
Strict Intake/Output: Your doctor may need to know
the amount of liquid you are taking in versus the amount
you lose in your urine. This is often called an
"I&O."
-
Unless told otherwise, drink
6 to 8 large glasses of water each day. Keep a record of
exactly how much liquid you drink.
-
Your output of urine may have
to be measured. Ask your doctor whether it's OK to use the
toilet.
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