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How is placenta previa treated?

The most common symptom of placenta previa is bright red bleeding, usually with no pain or cramping. Your physician will order an ultrasound exam to determine the exact location of the placenta and blood tests to determine how much blood has been lost. Regular ultrasounds and nonstress tests will be performed to make certain the baby is well.

The treatment for placenta previa depends on how much bleeding has occurred. You may need a transfusion of blood. If you are late in your pregnancy, your doctor may decide to deliver your baby, depending on how much bleeding is occurring. If you have bleeding before your 37th week of pregnancy, you may remain hospitalized on bed rest until you are closer to term or until the bleeding or contractions disappear. Whether you are allowed to go home or remain in the hospital, it is important to let your nurse and physician know of any further bleeding episodes. When a complete previa exists, the baby must be delivered by cesarean section.

Dr. Deborah Raines, MSN
Nursing Specialist

Treatment of placenta previa is dependent upon the amount and severity of bleeding, the gestational age and condition of the fetus, and whether the bleeding has stopped.

If the woman is not actively bleeding the goal is to minimize pressure or force on the placenta that may initiate bleeding.

  • Avoid strenuous activities such as running, lifting or straining
  • Avoid sexual intercourse or inserting anything into the vagina and no pelvic examinations.
  • Avoid constipation and straining to defecate
  • Be on bed-rest or modified bedrest
  • Have immediate access to emergency care at an obstetrical medical center if bleeding begins.

If the woman begins to bleed:

  • Immediate care at an obstetrical medical center is needed.
  • If the woman or fetus is showing signs of distress from blood loss delivery of the fetus may be necessary.

If the bleeding decreases or stops delivery can be delayed and a watch and wait approach knows as expectant management is under-taken. Expectant management includes:

  • If the fetus is viable but premature corticosteroids may be administered to enhance fetal lung development in preparation for an early birth.
  • An amniocentesis may be performed to assess fetal pulmonary maturation.
  • The mother may be given iron supplements to prevent/treat anemia
  • Stool softeners and a high fiber diet to prevent constipation and straining with bowel movements.
  • Rh negative women may be given Rhogam to prevent development of antibodies (Rh sensitization.

If the bleeding does not stop:

  • The mother will remain hospitalized and closely monitored until the fetus is mature enough to be born or the mother is showing signs of distress due to blood loss.
  • Blood transfusions may be used to replace blood loss and prolong the pregnancy.
  • If the bleeding becomes severe and uncontrollable and emergency cesarean delivery is the definitive treatment.

Treatment options for placenta previa depend on the amount of bleeding you are experiencing. If you hardly notice any bleeding with the condition, you may be asked to go on typical bed rest until the time of your delivery. This means that you’ll need to stay at home and, for the most part, lie down rather than sitting, walking, or, generally, putting pressure on your pelvis. You will also be told to refrain from having sex or using any kind of tampons. While it may be possible to have a vaginal birth (if it appears the condition has resolved in weeks 32 to 35), concern for safety usually dictates the performance of a C-section. A C-section will definitely be performed, though, if you are showing any signs of severe bleeding.

If your case is more serious and you have heavier bleeding, your doctor might want to admit you to the hospital for bed rest. This way you will be closely monitored, just in case you need a blood transfusion or you begin to go into pre-term labor. While you’re in the hospital, you will most likely be scheduled for a C-section delivery.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.