How is it managed?
If you are aware that you have placenta previa, or you start to bleed more heavily than normal in labour, your caregiver would monitor any bleeding closely.
Other interventions can include:
Monitoring the baby
Monitoring the woman
Ultrasound
An internal vaginal examination
Epidural?
The baby
Monitoring the baby. The baby's heart rate would be continuously monitored with a
CTG machine, aimed at detecting if the blood being lost by the woman is affecting her baby. Blood loss from the placenta can affect the blood flow to the baby, and the transport of oxygen and nutrients to them. If severe, it can cause fetal distress, and be life threatening for the baby. If this were the case, a Caesarean would need to be performed.
Monitoring the woman. The woman's pulse and blood pressure would be monitored more closely, possibly every half an hour, instead of every 2 hours. An intravenous (IV) cannula would be placed in her arm, which can be used to attach to a drip if the bleeding became heavy. This is used to give fluids through the vein (or in severe cases) a blood transfusion. It can also be used if there is a need to go the operating theatre for an emergency Caesarean.
Ultrasound. A portable ultrasound may be brought into the labour room to investigate any heavy bleeding, if you are not aware that you have placenta previa. This will give your caregiver information about why you may be bleeding, if it is wise for you to continue labouring, and to let the doctor know where the placenta is actually lying, before a Caesarean is performed.
It can inform the surgeon about the best place to make the Caesarean incision, helping avoid cutting into the placenta during the operation. This risks blood loss from the baby, as well as the woman, but in some cases may be unavoidable, depending on where the placenta actually is.
An internal vaginal examination in the operating theatre.