Placenta Praevia

Placenta praevia is a condition in which the placenta attaches low in the uterus, partially or fully covering the cervix. It can cause serious bleeding, particularly as pregnancy progresses or during labour, and requires careful planning for delivery.

• Painless vaginal bleeding, typically occurring in the second half of pregnancy, which can range from light spotting to heavy bleeding
• Bleeding may occur without any obvious trigger, though it can sometimes follow sexual intercourse or physical activity
• In some cases, no bleeding occurs before labour begins, and the condition is identified on routine ultrasound

• Occurs when the placenta implants in the lower part of the uterus, near or over the cervix, rather than higher up as usual.
• Risk is increased by previous caesarean delivery, other previous uterine surgery, multiple pregnancy, increasing maternal age, and a history of placenta praevia in a previous pregnancy.

• Often identified on a routine antenatal ultrasound scan, sometimes before any symptoms occur.
• Any painless vaginal bleeding in the second half of pregnancy should prompt urgent ultrasound assessment to check the placenta's position, since placenta praevia is an important cause requiring specific management.
• A vaginal examination is generally avoided until placenta praevia has been excluded by ultrasound, as it can trigger significant bleeding if the condition is present.

Women diagnosed with placenta praevia require close antenatal monitoring, with delivery planning based on the exact position of the placenta and the presence or severity of bleeding.

Vaginal delivery is generally not safe if the placenta fully or significantly covers the cervix, and caesarean delivery is planned instead, timed based on gestational age and clinical circumstances.

Any significant bleeding during pregnancy requires urgent hospital assessment, as it can indicate a need for emergency delivery to protect the health of mother and baby.

Women are generally advised to avoid strenuous activity and sexual intercourse if placenta praevia is diagnosed, and to seek immediate care for any bleeding.

• Attend all recommended antenatal ultrasound scans, which allow early identification of placenta praevia.
• Seek immediate medical care for any vaginal bleeding during pregnancy, regardless of whether it is painful or painless.
• Follow specific activity restrictions advised by an antenatal care provider if placenta praevia is diagnosed.
• Plan delivery at a facility capable of managing this condition and providing emergency caesarean delivery if needed.