Sunday, February 5, 2012

Please don't come out first placenta!

Hola! Today i wanna share with you about an obstetric condition called Placenta Previa.

Most women, especially mommies (and some daddies) would be familiar with what a placenta is. It is basically your baby's life support when he is in your womb.

Previa, in latin means "going before". So technically, the 2 words combined together would mean the placenta is going before. but going before what? or who? in this case, it would be the baby. So the placenta is going first before the baby. Going where? going out lar!

To put it medically, the condition illustrates the placenta is situated right near or on top of the cervix, which is the beginning of your pelvic outlet during pregnancy. And this my dear mommies, is preferably  not  a wanted condition. 

Why? well first one needs to know what a placenta does. To summarize it, it is a means of communication between the mother and her growing baby. It also functions like a big filter of some sort. The mother's blood brings nutrients and oxygen to the baby by way of the placenta. So, by letting the placenta comes out first, it would be dangerous to both mom and baby. The terminal complication would be death.  How is it dangerous to the baby? well it's quite obvious that if the baby's life support is out first, the baby left inside would not survive right? it's like when an airplane's engine dies out, the plane will obviously not fly and plummets down! So when a placenta comes out, this means it has to be peeled off from the inside of the uterine wall. And yeap! with all the blood gushing out from the wall, the mother would succumb due to heavy bleeding and shock. Scary? you bet!

A picture paints a thousand words. so take a look at these:

These are the types or grading used medically to explain the condition. Their form of management also differs.

So i'm not going to explain lengthily about the complication or how placenta previa can occur here. That one you can google yourself or ask your specialist if you're interested. What i am keen to share is what basic management is done when one is diagnosed with this condition.

Usually a scan to roughly know the location of the placenta is done around 20 weeks of gestation. And by 32 to 34 weeks, the specialist will tell you whether you have a placenta previa or not. And then would he proceed with the appropriate management depending on the stage of the previa. Basically not all symptomless pregnancies with a low-lying placenta have to deliver their babies by caesarean section. There are studies where these mothers can deliver normally (vaginally ok) and without imposed harm to her and baby. But of course, if it is a complete (major) placenta previa like in the picture above, then a scheduled c-section is warranted.

For both partial and major placenta previa, bed rest is needed for the mother. Depends on the degree of the condition, and not to mention the kindness of the doctor, one is either warded in the hospital for monitoring till the planned delivery date, or given a long MC to rest at home with frequent follow-ups. SO FAR no management (that i know) allows patients with this condition to resume daily activities as per normal! This is either bad practice from the doctor, OR that mom is not at risk to have a low-lying placenta in the first place! and if you don't have it, then you definitely DO NOT NEED a planned c-section for it! Because there's no solid reason to do so! But nak buat macam mana?! Some people just don't bother to explain and some just don't bother to know or ask. I don't care how one chooses their fate, but i am allergic to those who rests them ALL on other people, and some would claim it's from God (eeeee!!!). If i'm not mistaken (and i don't need a medical background for this fact!), but He did give us all a brain when we were created, no?

Alright. i'm getting all emotional now. Not for no particular reason. But because it has happened to some patients before. So yeah, knowledge is THAT important. At the moment, i'm still not giving up to share what basic things i know. And with the invention of google, wikipedia and youtube, we are soooo blessed that knowledge is at the very cuticle of our nails! But one can only bring the horse to the water. Not more than that.

So with that, i end my post with my references on this brief topic. If you don't understand them, you can always ask more about it from your doctor.

Till then. Happy learning!

References i used are:
  1. Placenta Previa - PubMed Health
  2. Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management from Greentop Guidelines.

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