Placenta Previa: Causes, Complications, and Management Methods

The placenta is a paired organ that delivers oxygen and nutrients to the fetus during pregnancy. Unfortunately, sometimes placental issues arise, one of which is a low-lying placenta, also called placenta previa. If the placenta is near the cervix during the first trimester, there’s usually no cause for concern. As the uterus grows with the developing fetus, the placenta often moves upward, increasing the likelihood that it will shift away from the cervix. However, if this condition persists into the later months of pregnancy, a cesarean section may become necessary.

What Is a Low-Lying Placenta?
A low-lying placenta occurs when the placenta partially or completely covers the cervix in the final months of pregnancy. This can cause significant bleeding during labor or even before delivery.

Rest is the primary recommendation for managing this condition. In cases of severe bleeding, an emergency cesarean may be required.

Throughout pregnancy, the placenta grows week by week inside the uterus, providing oxygen and nutrients to the fetus while removing waste products from fetal blood. After birth, the placenta is expelled from the body. As the uterus expands during pregnancy, the placenta naturally shifts. Placement of the placenta at the lower uterus in early pregnancy is normal. Over time, as the uterus grows, the placenta typically moves toward the upper part of the uterus. By the third trimester, the placenta should be near the top of the uterus to allow a safe path for vaginal delivery. If the placenta remains low and covers part or all of the cervix in the final months, this is considered placenta previa. Rest can help improve this condition.

Causes of Low-Lying Placenta
The exact cause of placenta previa is not fully understood, but several factors may increase the risk:

• First pregnancy at an older age

• Uterine scars from previous procedures, such as curettage or miscarriage

• Previous cesarean deliveries

• History of low-lying placenta in prior pregnancies

• Multiple pregnancies (twins or more)

• Certain medical conditions such as endometriosis or uterine inflammation

• Smoking increases the risk of low-lying placenta

Symptoms of Low-Lying Placenta
The main symptom is bleeding, which can range from mild to severe. Immediate medical attention is required if any of the following occur:

• Severe cramps or pain

• Intermittent bleeding that stops and restarts after days or weeks

• Bleeding after sexual intercourse

• Bleeding in the second half of pregnancy

Complications of Low-Lying Placenta
Placenta previa is generally not dangerous in itself, and in most cases, the placenta moves upward by the end of pregnancy, allowing for normal delivery. Possible complications include:

• Increased likelihood of emergency cesarean

• Heavy bleeding due to cervical dilation or placental rupture before or during labor

• Preterm birth

• Insufficient oxygen supply to the fetus due to bleeding

• Difficulty with vaginal delivery

With proper medical supervision, most women can safely have either vaginal delivery or cesarean.

Sleeping Positions During Low-Lying Placenta
There is no unique sleeping position that moves the placenta, but in severe cases with heavy bleeding, doctors may recommend complete bed rest. Mothers should avoid getting up entirely, even to sit. During rest, lying on the left side is advised to promote proper blood flow to the uterus and healthy fetal growth. Sleeping on the back should be avoided.

Other Treatments for Low-Lying Placenta
Currently, there is no medical treatment to cure placenta previa. However, bleeding can be managed depending on the severity, gestational age, and the health of both mother and fetus. Minor bleeding can often be managed with rest. Severe bleeding may require blood transfusions. If the pregnancy is beyond 36 weeks, cesarean delivery is usually preferred. In cases of uncontrolled bleeding, an emergency cesarean may be performed even if the baby is premature.