Placental Previa & Bleeding: Understanding Risks and Treatment

Question
i have been diagonised with total placental previa,and i started bleeding at week 27.now i am at week 32 and my doctor has prescribed corticosteroids,and c section after week 36.but he also said that there is always arisk of heavy bleeding during c section which can be life threatning.i am in great fear,and iwant to know if it is a life threatning condition.

Answer
Dear Banani,

Total placenta previa occurs when the internal cervical os is completely covered by the placenta. If you have placenta previa, your doctor will monitor you and your baby carefully to reduce the risk of these serious complications:

1. Bleeding - One of the biggest concerns with placenta previa is the risk of severe vaginal bleeding (hemorrhage) during labor, delivery or the first few hours after delivery. The bleeding can be heavy enough to cause maternal shock or even death.
2. Premature birth - Severe bleeding may prompt an emergency C-section before your baby is full-term.
3. Placenta accreta - If the placenta implants too deeply and firmly into the uterine wall, the placenta may not spontaneously detach from the uterus after delivery - an uncommon condition known as placenta accreta. This can result in severe bleeding and, often, the need for surgical removal of the uterus (hysterectomy).

Typically, for a total placental previa, the treatment is a scheduled C-section as soon as it can safely be performed (usually after 36 weeks). This tends to minimize the chances of severe complications. If you were to begin bleeding heavily prior to that time, an emergency C-section may be required. Your doctor has ordered the corticosteroids to mature your baby's lungs prior to any potential preterm delivery. Since you are getting closer to delivery time, most doctors will recommend bed rest and a pretty strong limitation of activity, including no sexual activity.

I know this can be frightening, but please know that it sounds like your doctor is absolutely on top of this. I have never in my career known a doctor not to try everything possible to achieve the most positive outcome with their patients. Just try to have some faith.

I hope this has helped you and answered your question. I wish you well.

Brenda