Treatment Overview

If you have placenta previa, your treatment will depend upon:

• How much you are bleeding (which influences whether you are monitored as an outpatient or in the hospital), whether you need a blood transfusion, and when delivery is necessary.
• Your overall physical condition, such as whether you've lost blood and are anemic.
• Your fetus's overall maturity and physical condition. Whenever possible, delivery is delayed until fetal lungs are mature.
• How much of your cervix is covered by the placenta. Because a vaginal delivery is likely to cause heavy placental bleeding, a cesarean is used for placenta previa deliveries.

If you have placenta previa and begin to bleed, you may be hospitalized. If your fetus is mature, you will have a cesarean delivery. If your bleeding slows down or stops, delivery can most likely be delayed. This watching and waiting approach is called expectant management. The course of expectant management is based on your and your fetus's condition.

• If your fetus is 24 to 34 weeks' gestation, you may be given corticosteroids to improve fetal lung development and prepare for an early birth. You may have an amniocentesis to see how developed your fetus's lungs are. You may also be given iron supplements to treat or prevent anemia and a high-fiber diet with stool softeners to ease any straining during a bowel movement.
• If you have Rh-negative blood, you will be given Rh immunoglobulin in case your fetus has Rh-positive blood. Should you be exposed to your fetus's Rh-positive blood without Rh immunoglobulin, your immune system will develop antibodies that are dangerous to an Rh-positive fetus (Rh sensitization). For more information, see the topic Rh Sensitization During Pregnancy.
• If your bleeding does not stop, expect to remain hospitalized and closely monitored until your fetus is mature enough to deliver. Moderate blood loss can be replaced with a blood transfusion to prolong your pregnancy until your fetus is mature enough to deliver.³
• If you have labor contractions, you may be given tocolytic medicine to slow or stop the contractions. But the benefit of tocolytic medicine in stopping labor is uncertain. For more information, see the topic Preterm Labor.
• Should bleeding become severe and uncontrollable, an immediate cesarean delivery, possibly with a blood transfusion, is the only treatment available for stopping it.

Delivery

Delivery involving placenta previa is done by cesarean section.

About 25 out of 100 women with placenta previa deliver their babies preterm (before the 37th week of pregnancy).³ Infant problems following placenta previa are usually related to prematurity. If your infant is premature, he or she may need care in a neonatal intensive care unit, or NICU. Care in the NICU can last days or weeks, depending on the extent of a baby's problems and the amount of care needed. For more information, see the topic Premature Infant.

Treatment for placenta previa can be done by:

• An obstetrician.
• A perinatologist.

Treatment for a premature infant can be provided by a neonatologist.