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Managing Low-Lying Placenta in the Second Trimester

Learn essential steps to manage a low-lying placenta during the second trimester for a healthy pregnancy journey.

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Dr. Priyanka Surisetty

At a Glance

Understanding Diagnosis

Diagnosed through an ultrasound scan at 18-21 weeks if the placenta is close to the cervix.

Regular Monitoring

Follow-up scans at 32 weeks to check for any changes in placental position.

Awareness of Symptoms

Watch for painless vaginal bleeding, especially post-intercourse or in later pregnancy stages.

Lifestyle Adjustments

Avoid intercourse and maintain a nutritious diet with possible iron supplements.

Preparation for Delivery

If still low-lying by 32 weeks, prepare for possible caesarean delivery and further monitoring.

In this article

  • Understanding Low-Lying Placenta and Its Grades
  • Recognising Symptoms and Signs of Low-Lying Placenta
  • Risk Factors for Developing Low-Lying Placenta
  • Monitoring Low-Lying Placenta Throughout the Pregnancy
  • Managing Daily Activities with Low-Lying Placenta
  • Conclusion

Undoubtedly, pregnancy is an exciting journey for mothers, but sometimes there is a chance of unexpected situations like low-lying placenta or placenta previa. It feels tough if you are diagnosed with such a condition, but rest assured, with regular monitoring, checkups, and proper precautions, you can still have a healthy pregnancy.

This article will explain everything about a low-lying placenta and how to manage it during the second trimester.  

Understanding Low-Lying Placenta and Its Grades

We know the placenta is a lifeline to the baby providing oxygen and nutrients while removing the excreted products. A normal placenta should be placed higher up in the uterus, away from the cervix. However, in some cases, it can get positioned lower and cause trouble during labour. If the placenta implants itself in the lower part of the uterus, this condition is called a low-lying placenta or placenta previa. Sometimes, such a placenta covers the cervix and blocks the birth canal at the time of delivery.

Unfortunately, this condition can't be seen in early pregnancy. Routine ultrasound scans can diagnose it only during and after the second trimester of pregnancy. While it might cause alarm, you don't need to worry too much - especially when diagnosed early.

Recognising Symptoms and Signs of Low-Lying Placenta

Usually, a low-lying placenta does not show any symptoms, especially in early pregnancy. But there are some signs you need to be aware of:

  • Vaginal bleeding: If you are experiencing painless vaginal bleeding, it might be a sign of placenta previa. you should contact your doctor immediately,no matter how light the bleeding is.
  • Reduced foetal movement: If the placenta is not supplying oxygen and nutrients as well as it should, it can cause a decrease in foetal movements.
  • Altered position of baby: The baby's position might be unusual such as sideways across the womb or breech.

Remember that placenta previa can not be identified through just these signs. This is one reason why regular ultrasound checkups are important during the second trimester. With timely diagnosis and monitoring, the chances of a healthy delivery are much higher.

Vaginal Bleeding: A Key Indicator

In the case of a low-lying placenta, you will observe unusual vaginal bleeding during the second trimester at around the 20th week of pregnancy. Unlike the typical spotting in the early stages of pregnancy, this causes noticeable bleeding. In such cases, it is better to consult a doctor immediately. Sometimes, the bleeding will stop on its own. Even if the bleeding stops, it is crucial to get checked thoroughly.

Diagnosing Low-Lying Placenta: Ultrasound Techniques

As mentioned earlier, the only way to confirm a low-lying placenta is through regular ultrasound scans. These scans allow your doctor to see the placenta's position and proximity to the cervix. A second trimester transabdominal ultrasound, where the probe is placed on the belly, can evaluate the position of the placenta.

In some cases, a transvaginal ultrasound, where the probe is inserted into the vagina can evaluate the placenta's position. However, this ultrasound is recommended only for a more precise view. Once placenta previa has been diagnosed, your doctor will schedule regular scans to monitor the changes in the placenta's position. 

Risk Factors for Developing Low-Lying Placenta

 

While any woman can experience a low-lying placenta during pregnancy, certain factors can increase the risks.

  • Women over the age of 35 are at a higher risk of having a low-lying placenta.
  • Women carrying twins or more are likely to be diagnosed with this condition.
  • The more pregnancies you had before, the higher the risk of placenta previa.
  • If you are habituated to smoking, it can increase the risk of placental issues.

Previous surgeries and reproductive procedures might cause placental problems in some cases. Let's look more closely into it.

Previous Uterine Surgeries and Reproductive Procedures

Uterine surgeries are one of the most significant causes of a low-lying placenta. Women who have had C-section deliveries before, or any other surgical procedures like fibroid removal, or uterus surgeries are more likely to experience placenta previa.

On the other hand, women who conceive through in-vitro fertilisation (IVF) are also at higher risk of placental problems. If you have a history of such surgeries earlier, it is better to inform your doctor so they can monitor your placenta more precisely. 

Monitoring Low-Lying Placenta Throughout the Pregnancy

If you are diagnosed with a low-lying placenta during pregnancy, your doctor will monitor it's position regularly. You will be suggested additional ultrasounds, especially during weeks 28 and 32 to check whether the placenta moves upwards as the uterus expands.

If you are approaching the due date, yet the placenta is still on the lower side, there is a possibility of a planned C-section to ensure your and your baby's safety. This extra monitoring can be overwhelming, but it is crucial for the baby's safety. Always be in touch with your doctor and keep monitoring the placenta's position for the safe delivery of your baby. 

Managing Daily Activities with Low-Lying Placenta

If you are diagnosed with this condition in the second trimester, there is no need to panic or to change your lifestyle drastically. The good news is that you can follow your daily routine with the right adjustments while minimising the risk of placenta previa. However, you need to follow up on your checkups regularly and keep monitoring the placenta's position with your doctor's help.

There is no need to be more cautious about every move or to be bedridden unless there are other risks. To minimise the risk, avoid heavy lifting, running too fast, and putting stress on your abdomen. Sleep comfortably and take proper rest when you need it.

Avoiding Potentially Harmful Activities

Although placenta previa management can be stressful, there is nothing to panic about. The key to managing the lower placenta is to avoid straining your abdominal area, and uterus. Here are some general precautions to follow:

  • Avoid lifting heavy objects that strain your abdominal muscles.
  • Gentle exercises like walking and swimming are fine, but avoiding high-impact exercises like jumping and running is better.
  • When seated for long periods, ensure that you are in a comfortable position.

Conclusion

Being diagnosed with a low-lying placenta can make you feel stressed, but with the right adjustments, care, and precautions, you can have a healthy pregnancy and normal delivery.

If the condition is diagnosed early and monitored correctly, there is nothing to worry about. It would be best to stay connected with your doctor to monitor your placenta's position regularly.

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FAQs

Can the placenta move upwards during the second trimester?

A: There is a possibility. As the pregnancy progresses, the placenta on the lower side can move upwards. With close monitoring and taking proper precautions, many women have successful pregnancies even with placenta previa.

The Is low-lying placenta dangerous?

A: Low-lying placenta can lead to complications like heavy vaginal bleeding or preterm labour. But, with the right precautions, and close monitoring by a doctor, you can have a healthy pregnancy and safe baby delivery.

What are the different placenta previa types?

A: There are four types of placenta previa: marginal, partial, complete, and low-lying. The severity depends on how much the cervix is covered with the placenta.

Can I have a normal pregnancy with a low-lying placenta?

A: Yes. In many cases, the low-lying placenta can move upwards without causing any complications. However, you need to follow your doctor's advice and keep up the monitoring.

Does every low-lying placenta case require a C-section?

A: Not necessarily. By the time you reach your third trimester, the placenta may move upwards as the pregnancy progresses. In some cases, if the position of the placenta has not changed, or covers the cervix completely, then there is a scope of c-section.