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    Low Lying Placenta

    What is a Low-Lying Placenta: Causes, Symptoms, Treatment, Risk factors and Travel Restrictions

    Updated on 2 November 2022

    When the placental structure is attached to the lower part of the uterus in proximity to the cervix, it is called the low-lying placenta. Learn more about it here.

    Introduction

    The placenta is a vital yet temporary organ that a woman’s body develops at conception to nourish the baby with essential nutrients, blood and oxygen. It also removes the waste from the body of the foetus. The development of a placenta can be detected in the early weeks of pregnancy, usually through an ultrasound. The placenta attaches itself to the lining of your womb. The placenta does not move from its attachment, but it can vary in size (Placental Migration) according to the growth of the uterus as the pregnancy progresses.

    What is a low-lying placenta?

    When the placental structure is attached to the lower part of the uterus near the cervix (the lower part of the uterus through which the baby is pushed out), a low-lying placenta is found in the ultrasound.

    A transvaginal scan is typical to find a low-lying placenta at 12 weeks of pregnancy. However, the placenta could move up later, causing little to no complications in labour and pregnancy. But in a few rare cases, the placenta could stay covering the cervix, partially or entirely blocking the birth route of the foetus. This condition is called placenta previa.

    Placenta previa can potentially cause risks in the delivery. Anterior Low-lying placenta is a condition when the placenta is fixed to the front wall of the uterus. The posterior low-lying placenta is when the same happens with the back wall of the uterus. The medical advisers will assist you in the pregnancy journey in such cases. Many studies have shown that a low-lying placenta could mean the baby will be a male child.

    What are the causes of a low lying placenta?

    A low-lying placenta may occur due for varied reasons:

    • Smoking or consuming drugs while pregnant can increase the chances of having a low-lying placenta.
    • Having had significant surgeries in and around the uterine organs can impact the position of the placenta in pregnancy.
    • People over 35 years of age may have a lower placental position during pregnancy.
    • A low placenta can occur when there has been a miscarriage in past pregnancies.
    • A previous birth through caesarean delivery can contribute to such a condition for later pregnancies.
    • Adopting fertility treatments to conceive, like in-vitro fertilisation, can impact the possibilities of this condition.
    • The placenta could be low when a mother is pregnant for the second time or with a twin or multiple foetuses.

    There are many reasons why this condition occurs during pregnancy, but it is essential to remember that a low-lying placenta is manageable. In addition, you can always reach out to your doctor to get clarity about the symptoms and treatment if your placenta is low-lying.

    What are the symptoms of a low-lying placenta?

    A low-lying placenta may show the following symptoms. If one or more of these persist, seek consultation from your practitioner:

    • Though spotting in the early weeks is a sign of pregnancy, the bleeding may follow through the second and third trimesters. This is the most common indication of placenta previa.
    • A baby inside the womb generally engages in the third trimester (from 30 to 34 weeks), but mothers with a low-lying placenta may find their babies still in breech or other unfavourable positions even in the last few weeks.
    • Cramps that mimic menstrual discomfort may occur frequently. This is also accompanied by bleeding.
    • It is always essential to keep track of your blood sugar and pressure levels during pregnancy. Women with lower placental positions experience high blood pressure (preeclampsia).

    What are the low-lying placenta risk factors?

    The risks of a low-lying placenta include:

    • Giving birth to preterm babies.
    • Babies may have restricted growth or sometimes possess congenital disabilities.
    • In addition, the mother sometimes may experience heavy bleeding, resulting in a hysterectomy (where the womb of a mother is removed).
    • Sometimes, a posterior low-lying placenta occurs where it could lie closer to reaching the internal Os (the opening at the centre of the cervix), thus causing difficult labour.
    • Another significant risk of a low-lying placenta is that the mother may have severe anxiety and not be able to cooperate with the procedures.

    What precautions and travel restrictions to take for a low-lying placenta?

    Although doctors and medical intervention cannot prevent the occurrence of placenta previa, they will always guide you with instructions and constant monitoring of the foetal and maternal well-being:

    • Doctors will also make prior arrangements, foreseeing cases of blood transfusions during labour.
    • Eating healthy and following a healthy lifestyle can rule out becoming anaemic during pregnancy.
    • Your physician may suggest you abstain from intercourse if you find yourself bleeding after.
    • Refraining from strenuous exercise routines and regular check-ups can help you stay positive.
    • It is wise to restrict travel with a low-lying placenta. Consider avoiding air travel.
    • Try to refrain from long-distance travel through other modes after 32-weeks.
    • Your care provider will instruct you on how much bed rest you need to cope with the impacts of placenta previa.
    • Medical health professionals advise that the right sleeping position for the low-lying placenta is by the left side so that there is the absence of pressure on the veins and shall ensure better blood supply.
    • As far as the sitting position for low-lying placenta is concerned, there are no restrictions but avoiding sitting for a long time.

    What are the treatments needed for a low-lying placenta?

    You will be requested to visit the hospital for frequent scans. For example, if your ultrasound shows signs of a low-lying placenta at 20 weeks, another scan will be scheduled at 32 weeks to find the position of the placenta.

    If the symptoms and blockage of the cervix continue to be visible even at 36 weeks, your doctor will plan your delivery with your consent at an early stage.

    This shall ensure the safety of the mother and the foetus. If the labour happens prematurely, you will be given steroid injections at 34 weeks to aid the maturity of the foetal lungs.

    Sometimes, things may not go as planned, especially with severe bleeding before delivery. As a result, the doctor may opt for an emergency C-section to avoid further complications.

    The low-lying placenta needs consistent monitoring, so please do not skip your consultations or scheduled scans. Instead, ask your health care providers questions to be updated on the health status of you and the little one.

    With early diagnosis and the right medical decisions, you and your baby can have a positive birthing experience.

    Summary

    • Low-lying placenta is a condition where the placenta is attached to the lower side of the uterus, potentially covering the cervix.
    • It may be caused due to previous birthing experiences, smoking or drug abuse, miscarriage and conceiving at an older age.
    • In most cases, the position of the placenta may turn out to be favourable after 30 weeks of gestation.
    • If the low-lying placenta persists in the third trimester, it may cause bleeding, difficulty in labour and premature deliveries.
    • In such cases, doctors may suggest early or caesarean labour.
    • It is essential to follow a healthy lifestyle, have regular check-ups, and keep in mind the travel restrictions in such pregnancies.

    References

    • Anderson-Bagga FM, Sze A. Placenta Previa. (2022). Placenta Previa. www.ncbi.nlm.nih.gov
    • NHS. (2018). What complications can affect the placenta?. www.nhs.uk
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