Complete placenta previa is a pregnancy complication where the placenta grows over the opening of the uterus. It can contribute to the development of an additional complication, placenta accreta, where the placenta embeds deeply into the uterine wall and does not expel normally after labor and delivery. This condition can be dangerous, and the patient will need close monitoring through her pregnancy to identify any complications as early as possible. She will also need a Caesarian section for delivery, as the placenta's position would hinder a vaginal delivery.
The causes of complete placenta previa are unclear. Patients with a history of uterine surgery as well as multiple births appear to be more at risk, but it can appear in any pregnancy. Patients with this condition will develop bleeding in the second half of their pregnancies. Some may also spot in the first trimester. An ultrasound can show the placenta out of position and provide information about the grade of the placenta previa; complete placenta is a grade IV, the most serious type, because it completely covers the cervix.
Pregnant women who develop this condition may need to rest to reduce the risk of pregnancy complications, and must avoid robust physical activity, especially if the bleeding is heavy. Their obstetricians will typically recommend regular checkups to monitor the pregnancy and the complete placenta previa. As the fetus grows, the doctor may also provide steroid injections to promote lung development. If the complete placenta previa starts to cause complications, early fetal lung development will make it safer to deliver immediately, as the infant will be able to breathe more easily.
As the pregnancy progresses, the patient will need to pick a delivery date to schedule a Caesarian section for the birth. The doctor can assist with this and will consult a gestational calendar to find out when the pregnancy should end. She may recommend a slightly early delivery so the patient does not go into labor before the surgery. In the surgical delivery, the doctor can also safely detach the placenta and provide medications to encourage the uterus to clamp back down and prevent hemorrhage.
Many patients successfully carry pregnancies to term with complete placenta previa, and there should be no future complications for the baby. Patients with a history of this condition may want to discuss it with their doctors when planning a pregnancy or receiving care for a pregnancy. There are no steps a patient can take to prevent a recurrence, but being aware of a past history can allow the doctor to screen early and identify it as soon as possible.
