Q. I am 21 weeks pregnant and my doctor just told me that I have marginal placenta previa. I went online to do some research about it and I am very confused. I have read some very contradictory things and just wanted to find out what it's all about. Any facts would be great! Thanks.
A. Placenta previa is a condition where the placenta is positioned in the lower half of the uterus and is covering, partially covering or touching the mouth of the uterus. As the pregnancy progress and the baby and uterus grow, the placenta usually moves upwards, away from the mouth.
You're only halfway through your pregnancy, so your placenta does have some time to properly reposition. Your doctor will probably monitor your condition with occasional sonograms.
If the placenta touches the mouth of the uterus, it may cause problems (bleeding, hemorrhaging or premature labor) late in pregnancy and/or during delivery, but only in a small percentage of cases. If the placenta is covering or partially covering the mouth of the uterus and the cervix, you may have to abstain from intercourse and will probably be scheduled for a C-section.
Q. I have placenta previa. My doctor told me not to have intercourse, but she did not say anything about having orgasms. Is it okay to have an orgasm when I have placenta previa?
A. If your doctor has advised against intercourse, it's probably because you may be at risk for premature labor or hemorrhaging if your cervix gets jostled. I hate to tell you, but I think this includes abstaining from orgasms as well. During orgasm your uterus contracts and spasms, which may disturb your cervix. I hope you don't have long to go!
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Q. As of 31 weeks, I still have complete placenta previa, with some spotting taking place. What are the chances that my placenta may still migrate up at this late date?
A. At 31 weeks with complete placenta previa, I think you have a small chance that the placenta will move up, but it may not completely disengage from the cervix. Your doctor will probably be monitoring you very closely over the next few weeks, checking the location of the placenta, the condition of the baby and any instance of bleeding. If your bleeding continues or gets heavier, you may be put on bed rest for the rest of your pregnancy. If by 36 weeks you still have complete placenta previa, your doctor will probably schedule you for a Cesarean section to prevent you from going into labor and possibly hemorrhaging. Try not to worry too much. With proper prenatal care, about 99 percent of women with placenta previa deliver perfectly normal, healthy babies.
Q. Last week I started to spot for about one hour. My doctor said my cervix was bleeding, red and irritated. He did an ultrasound to make sure it was not coming from the uterus and he was pretty sure it was from the cervix. The ultrasound also showed that the placenta is about an inch away from my cervix. I am scheduled for another ultrasound next week when I’ll be in my 18th week of pregnancy. Will this problem cause my cervix to become incompetent and lead to more problems in the future?
A. It sounds as if you have placenta previa, where the placenta touches, covers or partially covers the cervix. Experiencing bleeding and having an irritated cervix are very common with placenta previa. (See the other placenta previa questions for more details.)
Since you are less than halfway through your pregnancy and the placenta is already an inch away from the cervix, you have a very good chance for the placenta to move up and away from the cervix completely. And, having placenta previa does not mean that your cervix is incompetent. These two conditions are unrelated. With proper prenatal care, about 99 percent of women with placenta previa deliver perfectly normal, healthy babies.
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Q. I was diagnosed with complete placenta previa at 20 weeks. I am scheduled for another ultrasound at 26 weeks. I have been put on restricted activity and no intercourse. I have not experienced any bleeding to date, but I am extremely impatient waiting for the next ultrasound. What are the chances of having the complete previa disappear and migrate up away from the cervix?
-Anonymous, North Carolina
A. With 20 more weeks to go, you have a good chance for the placenta to move up and away from the cervix. The baby, placenta and uterus still have plenty of growing and shifting to do. What the actual percentages are, I couldn't tell you. You might try standing on your head for three hours a day to encourage the placenta to move upwards. Only kidding!!! I think you'll just have to wait and see.
Q. Last April I had a missed miscarriage. I was 20 weeks pregnant, but from the ultrasound the baby was about 15 weeks. This was my first ultrasound during this pregnancy, and it was found that I also had very low placenta. The doctor said I would have had a C-section if the pregnancy had continued. When asked what could have happened to lose the baby, he said he didn't know and it was probably a cord accident. There was no evidence of that in the ultrasound. Could it have been caused from having sex or exercise (I go to the gym) since my placenta was so low?
A. I doubt your miscarriage was a result of your physical activity or sexual relations. A low lying placenta or placenta previa may be aggravated by these things, but you would have had excessive bleeding right after. This kind of bleeding may stop on its own or it can develop into a miscarriage. Most women with complete placenta previa are advised not to have intercourse or take part in rigorous physical activity. (See the other placenta previa questions for more details.)
Since you didn't have excessive bleeding, it must have been another factor that caused the miscarriage, such as a genetic problem with development or a cord accident.
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Q. I'm 15 weeks pregnant and have been spotting and bleeding now for over a week, but experiencing no cramping or passing of tissue or blood clots. I found out last week that I have complete placenta previa. I'm just wondering if it's normal to bleed this early with placenta previa and if it's not, what is usually the outcome? Also, what are the risks for the baby and me?
A. It is normal to bleed occasionally with placenta previa. If you have complete placenta previa, where the placenta completely covers the cervical opening, your chances for bleeding episodes do increase. The proximity of the placenta irritates the already sensitive and engorged cervix. If the bleeding becomes heavy, your doctor may recommend bed rest. Complete placenta previa at the time of delivery could cause problems and you may need to be scheduled for a C-section. (See the other placenta previa questions for more details.) The good news is, at 15 weeks you still have a pretty good chance for the placenta to grow and move up and away from the cervix before the baby is born. My friend June had complete placenta previa at 20 weeks and hers moved by week 30!