Placenta Previa

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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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• Placenta Previa Overview
• Placenta Previa Causes
• Placenta Previa Symptoms
• When to Seek Medical Care
• Exams and Tests
• Placenta Previa Treatment
• Self-Care at Home
• Medical Treatment
• Medication
• Surgery
• Next Steps
• Follow-up
• Prevention
• Outlook
• Synonyms and Keywords
• Author and Editor
• Read more on Placenta Previa in Pregnancy from Healthwise

Placenta Previa Overview

Placenta previa is a complication of pregnancy in which the placenta (the organ that joins the mother and fetus and transfers oxygen and nutrients to the fetus) is implanted either near to or overlying the outlet of the uterus (womb). Placenta previa is found in approximately four out of every 1000 pregnancies beyond the 20th week of gestation. The main symptom of placenta previa is bleeding.

Several terms have been used to characterize placenta previa. The types of placenta previa include:

• Complete placenta previa refers to the situation in which the placenta completely covers the opening from the womb to the cervix.
  
  
• Partial placenta previa refers to the placenta that partially covers the cervical opening (since the cervical opening is not dilated until time for delivery approaches, this type of placenta previa occurs after the cervix has begin to dilate).
  
  
• Marginal placenta previa refers to a placenta that is located adjacent to, but not covering, the cervical opening.
  
  
• The term low-lying placenta or low placenta has been used to refer both to placenta previa and marginal placenta previa.
  
  
• The terms anterior placenta previa and posterior placenta previa are sometimes used after ultrasound examination to further define the exact position of the placenta within the uterine cavity.

Placenta Previa Causes

A number of factors can increase the likelihood that the placenta will be located in the lower part of the womb and potentially cover the cervical opening.

Scar tissue in the upper regions of the uterus can promote growth of the placenta in the relatively unscarred lower segment of the uterus. Scarring of the tissues in the upper uterus can be a result of the following:

• prior Cesarean deliveries (placenta previa occurs in 10% of women who have had four or more Cesarean deliveries);
  
  
• prior D&C procedures (curettages) for miscarriages or induced abortions; and
  
  
• any surgery or instrumentation of the uterine cavity.

In some cases, placenta previa occurs because the placenta grows larger to compensate for decreased function (lowered ability to deliver oxygen and/or nutrients) or a need for greater function. This need for a larger placental area can increase a woman's risk of developing placenta previa. Examples include:

• multiple gestation (twins, triplets, etc.);
  
  
• cigarette smoking; and
  
  
• living at high altitude.

The risk of having placenta previa also increases with increasing maternal age and with the number of previous births. Women who have had placenta previa in one pregnancy are at greater risk for this complication in subsequent pregnancies. Asian women also have a slightly greater risk of placenta previa than women of other races, although the reason for this is unclear. Further, it has been noted that women carrying male fetuses are at slightly greater risk for placenta previa than are women carrying female fetuses.

Since the placenta normally migrates away from the cervical opening as pregnancy progresses, women in the earlier stages of pregnancy are more likely to have placenta previa than are women at term. Up to 6% of women between 10 and 20 weeks' gestation will have some evidence of placenta previa on ultrasound examination, but 90% of these cases resolve on their own as the pregnancy progresses.