Informative: PLACENTA PREVIA (PP)

Masa browse thru GHMB ada 1 post bertanyakan tentang Placenta Previa atau dikenali sebagai PP dikalangan wanita. PP ni actually satu keadaan di mana uri berada di bahagian bawah rahim semasa sedang mengandung. Setahu saya terdapat 4 jenis PP yang dikategorikan oleh pakar perubatan di mana Stage 1 merupakan keadaan yang paling kurang bahaya dan Stage 4 adalah keadaan yang boleh membahayakan kesihatan dan bayi dalam kandungan. 

Disebabkan saya kurang mahir subjek ni (maaf kerana saya tidak mengalaminya), maka saya telah menggunakan maklumat yang diberikan oleh http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001902/ 

Placenta previa is a complication of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix.

The placenta is the organ that nourishes the developing baby in the womb.

Causes, incidence, and risk factors

During pregnancy, the placenta moves as the uterus stretches and grows. In early pregnancy, a low-lying placenta is very common. But as the pregnancy progresses, the growing uterus should "pull" the placenta toward the top of the womb. By the third trimester, the placenta should be near the top of the uterus, leaving the opening of the cervix clear for the delivery.
Sometimes, though, the placenta remains in the lower portion of the uterus, partly or completely covering this opening. This is called a previa.
There are different forms of placenta previa:

• Marginal: The placenta is against the cervix but does not cover the opening.
• Partial: The placenta covers part of the cervical opening.
• Complete: The placenta completely covers the cervical opening.

Placenta previa occurs in 1 out of 200 pregnancies. It is more common in women who have:

• Abnormally developed uterus
• Many previous pregnancies
• Multiple pregnancy (twins, triplets, etc.)
• Scarring of the uterine wall caused by previous pregnancies, cesareans, uterine surgery, or abortions

Women who smoke or have their children at an older age may also have an increased risk. Possible causes of placenta previa include:

• Abnormal formation of the placenta
• Abnormal uterus
• Large placenta
• Scarred lining of the uterus (endometrium)

Symptoms

The main symptom of placenta previa is sudden, painless vaginal bleeding that often occurs near the end of the second trimester or beginning of the third trimester. In some cases, there is severe bleeding, or hemorrhage. The bleeding may stop on its own but can start again days or weeks later.
There may be uterine cramping with the bleeding. Labor sometimes starts within several days after heavy vaginal bleeding. However, in some cases, bleeding may not occur until after labor starts.

Complications

Risks to the mother include:

• Death
• Major bleeding (hemorrhage)
• Shock

There is also an increased risk for infection, blood clots, and necessary blood transfusions.

Prematurity (infant is less than 36 weeks gestation) causes most infant deaths in cases of placenta previa. The baby may lose blood if the placenta separates from the wall of the uterus during labor. The baby also can lose blood when the uterus is opened during a C-section delivery.