Placenta previa during pregnancy is considered one of the serious complications during pregnancy and subsequent childbirth. The fact is that the situation when the placenta completely or partially covers the uterine os, and this is placenta previa, is irreparable - there is no way to correct this state of affairs with medication, although there is always a chance that it will displace on its own from the lower parts of the uterus.

The only symptoms that may indicate placenta previa during pregnancy are painless bleeding. They usually appear closer to the second half of pregnancy against the background of complete well-being.

Causes of placenta previa

Placenta previa is diagnosed using ultrasound, and the final diagnosis can be made after 24 weeks - before that there is a chance that the placenta will change position on its own. In addition to the fact that ultrasound determines the final diagnosis of placenta previa, this method also makes it possible to determine the variants of presentation, the size and area of ​​the placenta, and the degree of abruption.

The reasons for the occurrence of placenta previa during pregnancy can be changes in the mucous membrane of the inner wall of the uterus as a result of repeated abortions, inflammation or sexually transmitted infections, or previous complicated childbirth.

Predisposition to such pathology is more common in women with deformities of the uterine cavity caused by congenital anomalies or acquired (for example, as a result of uterine fibroids).

The cause of placenta previa can even be diseases of the heart, liver or kidneys, accompanied by congestion in the pelvic organs (including the uterus).

In addition, placenta previa is three times more common in women who are giving birth more than once.

Depending on the location of the placenta, there are low presentation(attachment) of the placenta, complete (central) or partial presentation (can be lateral or marginal).

Low placenta previa

During a normal pregnancy, the placenta is located along the bottom or body of the uterus, along the anterior (less often posterior) wall with a transition to the lateral walls. Low placenta previa is characterized by a situation where the placenta is located in close proximity to the internal os of the cervix - at a distance of 6 cm or even less.

This pathology is most often determined in the second trimester of pregnancy during the next ultrasound. But at the same time, if low placenta previa was diagnosed during this period, there is a possibility that over time, as pregnancy progresses, the placenta will take a “normal position”.

Conventionally, this state of affairs is called “migration,” and the movement of the placenta is caused by stretching and stretching of the uterine tissue. So, as the fetus develops, elastic fabrics the lower part of the uterus gradually rises upward. At the same time, some upward movement of the placenta occurs, due to which its location becomes normal. Therefore, if a low location of the placenta was discovered in the second trimester of pregnancy, there is a fairly high probability that it will move towards the end of pregnancy and the situation will normalize.

Regional placenta previa

Partial or incomplete placenta previa refers to its location in which the internal os of the uterus is blocked by the placenta, but not completely. One type of partial placenta previa is marginal placenta previa.

With the marginal location of the placenta, its lower edge is at the level of the edge of the internal os, while the outlet of the uterus is covered by approximately a third by placental tissue.

Usually, marginal placenta previa is diagnosed in the second trimester of pregnancy using ultrasound, against the background of complaints from the pregnant woman of constant bleeding. If marginal placenta previa has been determined, the woman requires careful medical observation and all necessary studies. Iron-containing drugs may be prescribed as necessary to avoid bleeding and the development of anemia due to a decrease in hemoglobin levels.

Complete placenta previa (central placenta previa)

Complete placenta previa is probably the most serious pathology associated with improper placement of the placenta. We speak of complete presentation when the placenta completely closes the internal os; during a vaginal examination, placental tissue is detected everywhere; the fetal membranes are not palpable. If, in addition, it is possible to establish that the center of the placenta is located at the level of the pharynx, a diagnosis of “central placenta previa” is made.

Partial placenta previa is diagnosed with a frequency of 70-80% of the total number of presentations. At the same time, complete presentation occurs in 20-30% of cases, and this, unfortunately, is not a small indicator.

With complete placenta previa, the woman, even in the absence of bleeding, must be sent to the hospital. Diagnosed central presentation is a serious pathology in which the pregnant woman should be provided with constant qualified medical supervision.

Treatment of placenta previa

If previa is detected, the doctor will decide on the treatment regimen and subsequent actions based on the specifics of placenta previa. But, be that as it may, in the case when a pregnant woman was diagnosed with placenta previa, she will need constant supervision by specialists.

If no bleeding is observed, the expectant mother may be allowed to be observed on an outpatient basis. At the same time, she needs to avoid stress - both physical and emotional, exclude sexual contact, sleep at least 8 hours a day and walk as much as possible. You will also need a special diet that involves consuming foods rich in iron, protein and vitamins. A diet is necessary to maximize the intake of useful substances into the pregnant woman’s body: with placenta previa, part of it does not participate in gas exchange, which can provoke. Meanwhile, the mother may experience anemia or anemia, which also becomes a consequence of placenta previa during pregnancy.

If, after 24 weeks, a pregnant woman experiences periodic bleeding, she will be asked to go to a hospital, where she can always be treated emergency assistance in case possible complications. In this case, doctors recommend inpatient observation until the end of pregnancy. If the bleeding is minor and the woman’s well-being has not deteriorated, they resort to conservative treatment methods: the pregnant woman is prescribed bed rest, complete rest, and medications that reduce the tone of the uterus and improve blood circulation. If detected in a future mother, she is prescribed drugs to increase hemoglobin levels, as well as means for general strengthening of the body.

Childbirth with placenta previa

Placenta previa during pregnancy is an indication for delivery by caesarean section, in the case of complete presentation - mandatory, since other ways of delivery are impossible. If the pregnancy has been preserved, a cesarean section is performed at 38-39 weeks.

With incomplete placenta previa, childbirth is possible, but it is associated with a certain risk. In addition, for natural childbirth with incomplete placenta previa mandatory conditions it becomes mandatory to stop bleeding after opening the amniotic sac, mature cervix, good labor activity and cephalic presentation of the fetus. In other cases, if childbirth proceeds naturally, there is a high risk of complete detachment of the placenta, which will lead to very heavy bleeding. And this is fraught with serious complications - even death for both mother and baby.

Especially for- Tatyana Argamakova

Normal fetal development during pregnancy is possible only with the correct functioning and location of the placenta. In some cases (less than 1% of the total number of births), placenta previa may occur, which can greatly complicate childbirth.

The placenta is an organ that is part of the structure of the uterus and contributes to the normal development of the fetus during pregnancy. However, the course of pregnancy is affected not only by the proper functioning of the placenta, but also by its location. Pathologies of the location of the placenta in the uterus are called placenta previa and are an uncommon complication of pregnancy.

Reasons

According to the causes of formation, placenta previa can be classified into two groups:

  • associated with the condition of the woman’s body,
  • associated with the developmental characteristics of the fertilized egg.

In most cases, the cause of placenta previa is the development of pathological changes in the uterine mucosa, leading to disturbances in the normal decidual reaction of the endometrium. These include:

  • chronic inflammation of the endometrium,
  • surgeries on the uterus, including uterine perforation, conservative myomectomy, cesarean section, etc.,
  • developmental abnormalities or underdevelopment of the uterus,
  • uterine fibroids,
  • complications of the postpartum period,
  • multiple births ( repeat pregnancy increases the likelihood of placenta previa by 3 times, since by the second birth a woman accumulates a significant number of gynecological ailments).

If the nidation function of the trophoblast is impaired (the delayed appearance of enzymatic processes in it), then the timely grafting of a fertilized egg in the area of ​​the uterine fundus is impossible, and it is grafted only in the lower parts of the uterus. Serious diseases of the liver, kidneys and heart can also lead to placenta previa, as they cause congestion in the pelvic organs. The result of these phenomena is a deterioration in the blood supply conditions in some areas of the uterine wall.

Migration of the placenta is also possible, which can be monitored using ultrasound. The initial stage of pregnancy is characterized by a central presentation of the branched chorion, and by birth the placenta can be located normally or low. In some cases, placenta previa is combined with its tight attachment, causing difficulties with independent separation after childbirth.
In general, it is more correct to diagnose “placenta previa” in the second half of pregnancy, since the position of the placenta may change (except in the case of central placenta previa).

Symptoms

The main symptom of placenta previa is spotting, which is also the main complication of this disease. The type of presentation determines in what period of pregnancy bleeding occurs and its intensity. For example, central placenta previa often leads to the early (2nd trimester) occurrence of intense bleeding, and marginal or lateral placenta previa leads to the onset of light bleeding in the 3rd trimester or during childbirth.

In most cases, the appearance of bleeding is observed in the 28th – 32nd week of pregnancy due to the greater severity of the preparatory activity of the lower segment of the uterus during this period. Between the 16th and 28th weeks of pregnancy, only 20% of cases of bleeding occur.

The main reason for bleeding during placenta previa is the constant increase in the size of the uterus throughout pregnancy: at the beginning its size is equivalent to a matchbox, and by the end of pregnancy the weight of the uterus can reach 1 kg (its volume is equivalent to the volume of the fetus, placenta, amniotic fluid and shells). Such a significant increase in the size of the uterus is possible due to an increase in the volume of each fiber from its structure. The maximum change in the size of the uterus is observed in its lower region and closer to childbirth. The location of the placenta in this place leads to the fact that the placental tissue, which is not elastic, does not have time to adapt to the more rapidly changing dimensions of the uterine wall. The result of this is the detachment of a section of the placenta in which the vessels are damaged and bleeding occurs.

Placenta previa always causes external bleeding, in which blood passes through the cervical canal to the outside, rather than accumulating between its wall and the placenta, forming a hematoma. The onset of such bleeding is usually unexpected and does not cause pain. Thus, they can be distinguished from bleeding that occurs during premature termination of pregnancy (accompanied by cramping pain). The first bleeding inevitably entails subsequent bleeding, occurring with varying frequency, duration and intensity.

The appearance of bleeding after the 26th - 28th week of pregnancy can be caused by physical activity, sexual intercourse and an increase in intra-abdominal pressure, including examination by a gynecologist. Therefore, a gynecological examination of women with placenta previa must be carried out with all precautions and in a hospital setting that provides emergency care if necessary. Prolonged bleeding poses a danger to the life of the child and mother.

Why is it dangerous?

Why is placenta previa dangerous? Anomalies in the location of the placenta are dangerous for both the baby and the mother.
And all because the walls of the uterus constantly stretch as the gestation period and the size of the fetus increase. At the same time, the risk of premature placental abruption increases significantly, as a result of which the baby loses contact with the mother’s body and, in the absence of timely medical care, may die from an acute lack of oxygen and malnutrition.
The mother is also in danger: during the process of placental abruption, massive bleeding may develop.

Therefore, if at the time of birth the placenta still covers the internal os of the cervix, childbirth naturally is impossible. After all, the process of childbirth begins with the opening of the cervix, accompanied by stretching of the internal os, the outcome of which can be placental abruption, which will lead to bleeding and life expectant mother and the baby will be at risk.

Diagnostics

In most cases, diagnosis of placenta previa occurs in the 2nd trimester of pregnancy and is based on complaints of periodic bleeding. There is no pain in this case. During examination (or ultrasound) it may be revealed incorrect position the fetus, as well as the high standing of the presenting parts of the child above the passage into the pelvis (due to the low location of the placenta preventing them from lowering into the underlying part).

The most objective, accurate and safe method obtaining information about the movement and location of the placenta is ultrasound. In practice, a three-time ultrasound is used - at the 16th, 24th - 26th and 34th - 36th week. If these examinations did not reveal any pathologies in the location of the placenta, then most likely the cause of bleeding is other factors (for example, the presence of pathological lesions of the cervix and vaginal area).

Dangers of pathology

Placenta previa often increases the likelihood of threatened miscarriage and the development of hypotension (stable decrease in blood pressure). Hypotension leads to weakness, decreased performance, fainting and headaches. In addition, bleeding can often cause anemia, which reduces the level of hemoglobin in the blood. As a result, symptoms of hypotension may worsen and fetal development may slow down (growth retardation). In addition, in the first year of life, children of mothers who suffered from anemia during pregnancy have a reduced level of hemoglobin, which causes a decrease in the body's immunity.

The location of the placenta in the lower part of the uterus often leads to the fetus occupying an incorrect position (oblique, transverse). The fetus may not be positioned with its head, as usual, but with its legs or buttocks towards the exit of the uterus. This will require surgical intervention during childbirth, since it is not possible naturally.

Species

1. Presentation on the anterior wall. This is more likely not a diagnosis, but simply a statement of fact and it is not at all necessary that any complications will follow, although the risk of their development cannot be completely excluded. Ideally, the placenta should be located along the back wall of the uterus, since this is the place where the uterus is least susceptible to changes during pregnancy.

The anterior wall intensively stretches and becomes thinner, which can lead to placental abruption or its further displacement to the uterine os.

2. Inferior placenta previa. Normally, the placenta is located at the bottom of the uterus. We know that the uterine fundus is on top, therefore, the pharynx is on the bottom. When the placenta is located low (low placentation), it is attached closer to the pharynx, reaching it by less than 6 cm.

In this case, 2 scenarios are possible: either the placenta will descend even more, and we can talk about complete or partial presentation, or it will rise up to the bottom along with the walls of the uterus increasing in size. With low placentation, natural childbirth usually occurs without problems.

3. Incomplete (partial) placenta previa. There are two types of this presentation: lateral and marginal. With lateral presentation, the placenta covers the internal os (exit from the body of the uterus into the cervix) by 2/3. At the edge - by 1/3. There is no need to panic if you have been diagnosed with partial presentation.

Very often the placenta moves into the correct position before birth. There is a high probability that the birth will be successful naturally, but everything is decided individually in each case.

4. Full (central) presentation. The most severe case of abnormal location of the placenta. The placental tissue completely covers the uterine os, that is, the child simply will not be able to enter the birth canal. In addition, the pathology is also dangerous for the life of the mother, since the pharynx area is the most extensible part of the uterus, which cannot be said about the placenta.

The uterus increases in size and placental tissue is detached, which cannot stretch as effectively and quickly. The integrity of the blood vessels is disrupted, which leads to severe bleeding, which, with complete placenta previa, can begin as early as the second trimester and bother the woman until childbirth. Childbirth is possible only by caesarean section.

How is pregnancy and childbirth going?

Caesarean section for placenta previa is required at 38 weeks of pregnancy. Natural childbirth in this case, they are dangerous due to severe bleeding, which threatens the life of the child and mother and occurs as a result of placental abruption when the child tries to exit. A caesarean section is also prescribed in the following cases:

  • placenta previa, accompanied by intense bleeding that threatens life,
  • repeated bleeding with severe hypotension and anemia, not eliminated by taking special medications and combined with fetal pathologies,
  • the presence of other uterine pathology in case of partial placenta previa.

Natural birth is possible in pregnant women with partial placenta previa who carry the fetus to term. The final location of the placenta is determined when the cervix is ​​dilated by 5 cm. A small partial presentation and minor bleeding require opening of the membranes, leading to lowering of the fetal head and compression of the bleeding vessels. As a result, the bleeding stops and childbirth occurs naturally. If bleeding continues, surgical intervention is required.

Regional placenta previa is an anomaly in the location of the fetus in the mother's body. This feature can negatively affect the health of the mother and baby. There are several types of this location of the fetus, with any of them it is necessary to constantly examine the woman and prescribe medications or exercise therapy. Such patients are usually hospitalized in the clinic to monitor the dynamics of the pregnant woman’s condition.

The prognosis is favorable. But when the first symptoms of this pathology appear, you need to consult a doctor for advice.

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    Regional placenta previa: what is it?

    Regional placenta previa - attachmentembryoat the 28th week of pregnancy or more, in which partial (incomplete) pregnancy occursoverlap of the internal os of the uterus, i.e. overlap of the segment. This condition may have a different etiology, for example, associated with improper attachment of the trophoblast during implantation or the anatomical features of the muscular layer of the uterus. Impaired muscle structure also appears due to inflammation due to infections that are sexually transmitted.

    Normal location and marginal presentation of the chorion

    The pathogenesis is also related to the fact that marginal placenta previa is possible with thinning of the myometrium, which is often caused by frequent curettages and abortions. Deformation of the uterus due to benign tumors and congenital pathologies also affects. In diseases of the cardiovascular system, the disorder in question is also possible.

    The formation of anomalous presentation is influenced by age factors (age more than 36 years and less than 18). Carrying twins or menstrual irregularities due to hormonal imbalance can also affect the appearance of this pathology. Anomalies in the development of the embryo also contribute to the incorrect location of the chorion. Due to insufficient blood circulation, the placenta cannot attach properly.

    A large number of births in history can also affect the abnormal placental presentation, and the location of the placenta in a previous pregnancy affects the future location of the chorion.

    Features of the location of the chorion

    After 16 weeks of pregnancy, the placenta (baby place) is formed in the uterus, which connects the body of mother and child. Through it, breathing and nutrition of the fetus are carried out, and metabolic products are excreted. The placenta resembles a disk with a diameter of 15-20 cm and a thickness of 2-4 cm.

    Normally, the chorion is located in the area of ​​the uterus and is not adjacent to the pharynx. The fetal part of the organ is covered with villi, which are supplied by small vessels from the navel. The umbilical cord is attached to it.

    On the side of the uterus, at the placenta attachment site, thickening of the inner lining is observed. The umbilical cord connects the fetus to the placenta. One end of it is attached to the umbilical region of the fetus, the other to the placenta.

    Inside the umbilical cord there are two arteries and a vein that carry blood from the fetus to the placenta and back. The umbilical cord vein carries oxygenated blood. Through the arteries - venous, which is saturated with carbon dioxide.

    Umbilical cord and normal fetal position

    During normal pregnancy, the chorion is close to the fundus of the uterus. This creates favorable conditions for fetal development.

    A low-lying placenta is abnormal. In this case, its lower part is no more than 6 cm away from the internal os of the uterus. There is a complete and central location of the placenta, which is manifested by complete closure of the internal os. Partial presentation, which includes the marginal and lateral form, is characterized by the fact that the placenta covers most of the outlet of the cervix.


    Main features and types

    According to the classification, there are two types of marginal presentation of the chorion: along the anterior wall and along the posterior wall. In the first form, mechanical damage to the placenta and its detachment occurs due to physical activity woman and baby's movements. Localization along the posterior wall does not have such severe consequences.

    With marginal placenta previa, patients complain of bleeding at night or at rest. The amount of blood loss depends on the severity of the pathology and vascular damage. Bleeding may be due to physical activity, sexual intercourse and fetal activity, examination by a gynecologist.

    A woman develops symptoms such as a feeling of discomfort in the lower abdomen and increased tone muscles of the uterus. If regular bleeding occurs, anemia develops. Against this background, the woman experiences increased fatigue, decreased performance and weakness. Hypoxia is noted due to a lack of nutrient supply.

    Marginal placental presentation often threatens miscarriage.

    Examination and treatment

    Diagnosis is carried out by a gynecologist based on complaints and ultrasound. Thanks to this method, it is possible to assess the location of the placenta and the degree of overlap of the uterine os. Treatment depends on symptoms, length of pregnancy, and the health of the mother and fetus. Therapy is carried out in a hospital setting.

    Doctors recommend being completely at rest with this type of pathology, excluding sexual intercourse and avoiding stressful situations. It is recommended to wear a bandage. In the second trimester of pregnancy, the location of the placenta can be changed with the help of physical therapy.

    Women with Rh-negative blood are given immunoglobulins.

    Due to the fact that the patient is developing anemia, she needs to eat more foods that contain large amounts of iron (buckwheat porridge, liver, beef, apples, red fish).

    In the absence of bleeding, women are regularly examined by a gynecologist, but are treated at home, that is, on an outpatient basis. They need to stay in bed proper nutrition and spend a lot of time in the fresh and warm air. It is recommended to constantly eat vegetables and fruits.

    Medicines

    For this pathology, they actively use medicines. To relieve uterine hypertonicity, you can use tocolytics (fenoterol, indomethacin, Ginipral) and antispasmodics (No-Shpa, Spanil).

    To treat anemia, it is recommended to use ferroceron, Kaferid, Hemofer, i.e. those medications that contain iron. In order to maintain the body's immune system, women are prescribed vitamin complexes. Sometimes antiplatelet agents are prescribed to stop bleeding (tirofiban, Zylt).


    To prevent placental abruption, pregnant women are prescribed progestin drugs (Duphaston, Utrozhestan). Some patients experience mental disorders such as depression. In order to relieve their manifestations, it is necessary to use sedatives based on valerian and motherwort.

    Stopping bleeding on your own with various medications is strictly prohibited, because the wrong dosage can lead to the death of the child.

    If certain medications are not suitable for the patient, the doctor should replace them with ones that are similar in action, but different in composition.

    Childbirth and consequences

    In case of intense bleeding, a caesarean section is resorted to. After giving birth, a woman is at high risk of complications such as bleeding and anemia due to decreased uterine contractions. In this case, the patient must remain in the hospital until complete recovery.

    Bleeding is associated with placental abruption. Sometimes it doesn't stop after a caesarean section. In such a situation, specialists may decide to perform a blood transfusion, which the girl’s close relatives donate in advance. Doctors often resort to removing the uterus to save a woman’s life.

    Sometimes intrauterine death of the fetus occurs due to a delay in its development and growth, and the death of the woman and child is also possible.

    If, with marginal placenta previa, no bleeding is observed and the condition of the woman’s body is normal, then natural childbirth is possible, but with the use of amniotomy (opening the membranes of the fetus). Natural childbirth is possible only in the following cases:

    • regular strong contractions;
    • uterus ready for childbirth.

    If this method does not bring positive results, then the woman is delivered through an abdominal incision.

    If the patient has pathologies according to ultrasound results and bleeding, then obstetricians consider early birth (up to 36 weeks). To prevent bleeding after childbirth, women are given oxytocin. After childbirth, women experience weakness and fatigue against the background of reduced blood pressure, and due to blood loss, a decrease in hemoglobin levels is possible.

    Prevention and prognosis

    The prognosis for this diagnosis is favorable. With proper treatment, constant examination and timely diagnosis, the fetus can be carried to 38 weeks and given birth healthy baby. Prevention of the pathology in question consists of timely treatment of all gynecological diseases before conceiving a child or pregnancy. It is necessary to avoid hypothermia.

    Gynecologists do not recommend resorting to abortion or uterine surgery. During pregnancy, you should avoid lifting weights and playing sports. A woman should be provided with a favorable psychological atmosphere so as not to provoke a miscarriage. Smoking and drinking alcohol are dangerous factors, because it is possible to develop other diseases that complicate the course of pregnancy.

The placenta is an organ that forms in the female uterus during pregnancy and provides communication between the organisms of the child and the mother. Intrauterine development, excretion of metabolic products, nutrition and respiration of the fetus - all this is carried out through the placenta.

Externally, the placenta looks like a disk. Its thickness is 2-4 cm, diameter is 15-20 cm, and weight is 0.5-0.6 kg, which is approximately 1/6 of the weight of the fetus. If the pregnancy proceeds normally, then the placenta, as a rule, is located in the area of ​​the uterus, not adjacent to the pharynx. However, it often happens that the placenta is positioned incorrectly. One of these cases is marginal placenta previa, in which the lower part of this organ lies at the level of the edge of the internal os.

Regional placenta previa: causes

All existing factors that provoke an abnormal location of the placenta in the body of a pregnant woman are divided into two groups. The first group includes factors related directly to the specific structure of the fetal egg. The fact is that disruption of the trophoblast implantation process and the late manifestation of enzymatic actions leads to untimely implantation of the fertilized egg into the upper part of the uterus, and therefore a marginal placenta occurs. If it persists until the 24th week of pregnancy or longer, they speak of the presence of marginal placenta previa.

The second group includes factors that directly depend on the characteristics of the body and the health status of the expectant mother. These include:

  • Pathological changes in the endometrium, contributing to disruption of the normal decidual reaction;
  • Diseases such as endocervicitis or endometriosis;
  • Uterine fibroids;
  • Pregnancy with more than one fetus.

A marginal placenta can be diagnosed using ultrasound.

Regional placenta previa: symptoms

The main manifestation of marginal placenta previa is bleeding that occurs during the third trimester of pregnancy, as well as during childbirth. These discharges are characterized by a sudden onset for no apparent reason, absence of accompanying pain and variable frequency. As a rule, it is not possible to determine their strength and duration in advance. In case of rupture of the marginal sinus of the placenta, presentation will be accompanied by heavy bleeding.

The diagnosis of “marginal placenta previa” requires regular medical supervision and timely implementation of all necessary tests. With such a common phenomenon as a decrease in hemoglobin, pregnant women are prescribed medications that contain iron. This will help avoid frequent and severe bleeding, as well as the rapid development of anemia.

Marginal placenta: consequences

What are the dangers of marginal placenta previa? As mentioned above, this deviation is fraught with bleeding, but this is not the only thing to be wary of. There is also a high probability that during birth process The baby, by squeezing the placenta, will cut off its own oxygen supply. In this regard, doctors usually insist that in case of marginal placenta previa, delivery is carried out by cesarean section.

Regional placenta previa: treatment

In order to raise the marginal placenta, they resort to either drug treatment or physical therapy in the form of electrophoresis with vitamins. In addition, experienced gynecologists recommend that women adhere to the following: simple rules during treatment of marginal placenta previa:

  • Wear a special bandage;
  • Get into the knee-elbow position for several minutes, five times a day, making sure that the time intervals between approaches are equal;
  • Avoid any physical activity;
  • Do not have sexual intercourse.

Compliance with the recommendations of the attending physician in most cases helps to raise the placenta to the desired level, and therefore the risk of complications during childbirth, and with it the need for a caesarean section, disappears.54 votes)

The ideal position of the placenta is closer to the fundus of the uterus, often on its anterior wall, and much less often on the posterior wall. The placenta cannot always attach and begin to fully develop in this place; then this vital organ for the baby is attached on the opposite side closer to the os of the uterus.

Depending on the placenta attachment site, there are:

  • full presentation;
  • central presentation;
  • lateral presentation;
  • marginal presentation.

Marginal placenta previa is determined during the second planned ultrasound; up to this point, the placenta can move and rise to a normal position from the previously fixed incorrect one. However, a final diagnosis can be made closer to birth. This pathology is referred to as partial presentation. With marginal presentation, the uterine os is blocked by the edges of the placenta by about a third.

Regional placenta previa - causes

The reasons for marginal presentation may lie in the woman’s health. Most often, the cause is previously experienced genital tract infections, abortions, as well as complications in the first pregnancy. In addition, presentation is observed in women who have been diagnosed with uterine fibroids or have a congenital pathology of uterine deformation. Endometriosis can also cause the placenta to not attach properly. After all, in this case ovum attached to the part of the uterus where the healthiest layer of the endometrium was. Incorrect location of the placenta is more often recorded in multiparous women.

With marginal presentation, a woman may begin to bleed. In this case, bleeding begins completely unexpectedly, without any discomfort or pain for the pregnant woman. Most often, the risk period begins in the third trimester at 28-32 weeks of pregnancy or during childbirth.

With abnormal placenta previa, including marginal placenta, the threat of miscarriage is diagnosed much more often. A pregnant woman may also experience hypotension – low blood pressure; and the development of anemia is possible. In addition, with marginal presentation, the child may take an incorrect position in the uterine cavity, which will require surgical intervention.

Regional placenta previa - treatment

As a rule, specific therapy is not used to treat marginal presentation. The main points are the complete or partial rest of the mother herself. This eliminates heavy lifting. It is better to refuse sex with marginal placenta previa, as with the other type.

And yet, with marginal presentation, constant medical monitoring and timely diagnosis are required. The main indicators that are worth monitoring are blood tests for hemoglobin and coagulation. Indeed, if anemia develops, a woman will need to be prescribed iron supplements. And blood clotting indicators should be normal in case of bleeding. Blood pressure is also measured regularly. And of course ultrasound examination, which can more accurately determine changes in the position of the placenta.

Childbirth with marginal placenta previa

The decision on how the birth will take place will be made by the attending physician, as well as the doctor who delivers the child. Therefore, it is better to contact the maternity hospital before the onset of contractions.

Childbirth with marginal placenta previa can occur naturally if there are no other indicators for this. With this diagnosis, bleeding, as a rule, is not profuse and stops as soon as the baby’s head covers the os of the uterus. However, there is always a high probability of completing labor surgically, because it is often possible to determine exactly how much the placenta has blocked the os of the uterus only after the cervix has opened by 5-6 cm.

With the level of modern diagnostics and medicine, a woman who is diagnosed with marginal placenta previa may not worry about her life and the life of her baby.