Sometimes the position of the placenta is close to the exit of the womb, or obstructing it.
If it is too close there is a problem during labour and delivery because the dilation of the cervix damages the placenta and causes excessive bleeding. If the exit of the womb is completely obstructed, it becomes impossible to deliver the baby safely vaginally; in these circumstances a casearean section will be performed. Placenta praevia is classified into four types:
Type 1: vaginal delivery is still possible and safe; Type 2: vaginal delivery may be possible, depending on the exact location of the placenta; Type 3: because the placenta precedes the baby, and bleeding is likely to be severe, vaginal delivery isn't possible; Type 4: because the placenta is located over the exit to the womb, vaginal delivery is impossible and a caesarean section is needed in order to protect the lives of both mother and baby.
Placenta praevia is usually diagnosed via ultrasound scanning. If, at an early scan the placenta appears to be low down, it will probably be recommended that another scan is done later on to check its position. Because of the way in which the womb expands, the placenta often seems to move up the wall of the womb. Without having a scan, the first sign of placenta praevia may be some degree of vaginal bleeding. There will be no pain associated with this. Any bleeding should be reported immediately to your midwife or doctor.
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