Placenta previa - part 2

What will happen if my previa persists?

If the follow-up ultrasound reveals that your placenta is still covering or too close to your cervix, you'll be monitored carefully, have regular ultrasounds, and need to watch for vaginal bleeding. You'll be put on "pelvic rest," which means no intercourse or vaginal exams for the rest of your pregnancy. And you'll be advised to take it easy and avoid activities that might provoke bleeding, such as strenuous housework or heavy lifting.

Bleeding from a placenta previa happens when the cervix begins to thin out or dilate (even a little) and disrupts the blood vessels in that area. It's usually painless, can start without warning, and can range from spotting to extremely heavy bleeding. If your bleeding is severe, you may have to deliver your baby right away, even if he's still premature. You may also need a blood transfusion.

It's unusual for bleeding to start before late in the second trimester, and about half the time it doesn't begin until you're nearly full-term (37 weeks). The bleeding will often stop on its own, but it's likely to start again at some point. (If you have bleeding and you're Rh negative, you'll need a shot of Rh immune globulin, unless the baby's father is Rh negative, too.)

If you start bleeding or have contractions, you'll need to be hospitalized. What happens then will depend on how far along you are in your pregnancy, how heavy the bleeding is, and how you and your baby are doing. If you're near full-term, your baby will be delivered by c-section right away. If your baby is still premature, he'll be delivered by c-section immediately if his condition warrants it or if you have heavy bleeding that doesn't stop.

Otherwise, you'll be watched in the hospital until the bleeding stops. If you're less than 34 weeks, you may be given corticosteriods to speed up your baby's lung development and to prevent other complications in case he ends up being delivered prematurely.

If the bleeding stops, and both you and your baby are in good condition, you'll probably be sent home. But you'll need to return to the hospital immediately if the bleeding starts again. If you and your baby continue to do well and you don't need to deliver early, you'll have a scheduled c-section at 37 weeks.

No matter when you deliver, if you still have placenta previa, you'll need a c-section. With a complete previa, the placenta blocks the baby's way out. And even if it's only bordering the cervix, you'll still need a c-section in most cases because the placenta could bleed profusely if the cervix dilated.