The location of the placenta is of great importance during pregnancy. The intrauterine development of the fetus even depends on the localization of the placenta. This article will help you understand what central placenta previa is and what this condition affects.
What is it?
Placental tissue appears in the immediate vicinity of the chorion attachment site. This feature is due to nature. Many arteries cross the placenta, which provide adequate blood flow to the fetus. Through the system of uteroplacental vessels, nutrients and oxygen enter the child's body. They are necessary in order for the child, who is in the mother's womb, to grow and develop quickly.
The best place for implantation (attachment) of a fertilized egg is in the area of the fundus of the uterus in the area of the back wall. This site has the most functional blood flow. If a small embryo is in this zone, then its intrauterine development proceeds quite well. However, there are other cases in medical practice. For certain reasons, a fertilized egg can descend into the lower parts of the uterus, where it is later attached. Such implantation largely leads to the fact that the placental tissue is formed below.
To separate the norm from pathology, doctors use a special conditional boundary. The reference point for determining placenta previa is the distance from it to the internal uterine os. Normally, in the second trimester of pregnancy, the distance from the throat to the placenta should be at least 5 cm.In the third trimester, it increases and is already 7 cm. If the placental tissue is much below this conditional border, then this condition is called the low position of the placenta. This clinical condition can worsen the course of pregnancy.
Another dangerous clinical condition associated with a too low placenta is presentation. This pathology is characterized by the location of the placental tissue on the internal uterine os. In this case, the severity of violations can be different. This depends largely on how much the placenta overlaps the internal uterine pharynx.
Doctors identify several types of placenta previa. One of the clinical options is the central presentation. With this pathology, the central part of the placenta enters the area of the internal uterine pharynx.
Features of the course of pregnancy
Central placenta previa can significantly complicate even the normal course of pregnancy. When establishing such a diagnosis, the expectant mother should carefully monitor her health. Usually, the first adverse symptoms appear by the middle of the second trimester of pregnancy. Subsequently, they can only increase. In some cases, it becomes too difficult to communicate a pregnancy. In such a situation, the baby may appear much earlier than the due date.
One of the alarming symptoms characteristic of this pathology may be bleeding from the genital tract. Its severity is very different. In some cases, women only notice blood on their underwear. With severe bleeding, blood loss can be quite profuse. Bleeding from the genital tract can develop with or without the development of pain in the abdomen. It is important to note that such bleeding during the entire period of pregnancy may appear several times.
Quite often, bleeding from the genital tract is the first symptom that makes a pregnant woman seek advice from an obstetrician-gynecologist. Next, the doctor conducts a clinical examination, during which he must determine the location of the placenta. If necessary, the obstetrician-gynecologist will send the expectant mother to undergo an ultrasound scan. An ultrasound examination of the uterus and its appendages is mandatory for all women with this pathology. It should be noted that the expectant mother will undergo an ultrasound scan several more times during the entire period of carrying the baby.
Repeated ultrasound examinations are necessary. This helps doctors track the dynamics of the development of this pathology.
It should be noted that the position of the placenta may change by the third trimester of pregnancy. If the placental tissue predominantly overlaps the internal uterine pharynx in the region of the anterior wall, then in such a situation it may be displaced upward. This process is called migration. Usually, the process of changing the initial position of the placenta takes several weeks.
It is possible to assess the migration of placental tissue only in the third trimester of pregnancy. Doctors must determine the localization of the placenta immediately before childbirth. This allows obstetricians-gynecologists to choose the right tactics of obstetrics.
Complications
The course of a pregnancy complicated by a central presentation can be quite unpredictable. At any time, the expectant mother may have complications. Reviews of women who had central placenta previa during pregnancy confirm this.
Bleeding from the genital tract with a central placenta previa can begin suddenly. In this case, a pregnant woman, as a rule, pours out a lot of blood from the vagina, and her general condition deteriorates sharply. Massive blood loss is an extremely dangerous condition. At this time, the uteroplacental blood flow is disrupted, which means that the baby is experiencing great discomfort. If the blood loss is very massive, then in such a situation the consequences for the child can be extremely unfavorable, up to the threat of his life. In such a situation, it is very important to seek medical help quickly.
If the condition of a pregnant woman and her baby has deteriorated greatly, then she must be hospitalized in a hospital for treatment and compensation for the violations that have arisen.
In some cases, blood loss may be frequent but not abundant. Usually such situations occur when the expectant mother violates the recommendations made for her by doctors. Bleeding may appear in this case after lifting heavy objects, as well as after playing sports.
For women who have a central placenta previa during pregnancy, in some cases, doctors may even recommend bed rest. The longer the pregnancy, the longer the expectant mother should rest. In this case, intense physical activity should be postponed for a while. Also, the expectant mother should monitor her psycho-emotional state. Strong nervous feelings and stress can have a negative impact on the course of pregnancy.
Obstetrics tactics
The management of pregnancy complicated by central presentation should be very careful. It is better for a pregnant woman who has this pathology to be supervised by an experienced and qualified doctor. During pregnancy, the expectant mother should impeccably follow all the recommendations of the doctors. This will help minimize the risk of possible conditions for both her and her baby.
When managing a pregnancy complicated by central placenta previa, doctors do everything possible to keep it as long as possible. In order for a baby to be born and be viable, he needs to go through several stages of intrauterine development. This takes several months. If heavy bleeding develops during such a complicated pregnancy, then the risk of developing spontaneous premature birth is very high. If labor starts too early, it can be extremely difficult for doctors to save the baby.
In pregnancy complicated by central presentation, doctors usually resort to a surgical method of obstetrics. Caesarean section helps reduce the risk of developing dangerous complications that can develop during a natural birth. The date of the delivery operation is always selected individually.
There are situations when the expectant mother goes to the hospital much earlier than the due date of birth. This usually happens if a woman has massive bleeding. In such a situation, doctors must assess the threat of the onset of premature birth. If the opening of the cervix is incomplete, then they can leave the woman in the hospital for a while.
The choice of tactics in this case largely depends on the duration of pregnancy. If the gestational age is already sufficient for the delivery operation, then the woman undergoes a cesarean section.
For what the central placenta previa means, see the next video.
