Is placenta previa surgery dangerous?

Women should pay special attention to the maintenance of their bodies after they become pregnant, have regular prenatal checkups, strengthen their diet and nutrition to be good for the development of the fetus, and avoid mental stress. Some pregnant women are diagnosed with placenta previa and need surgical treatment if necessary. Many women with placenta previa do not know whether the surgery is risky. Is surgery for placenta previa dangerous? Let’s take a look at it next.

1. Is placenta previa surgery dangerous?

Because pernicious placenta previa can cause severe obstetric bleeding in a short period of time, the operation is difficult, and the chance of cesarean section and hysterectomy and other surgical complications including bladder and ureteral injury, ureteral fistula or intestinal injury are significantly increased. At the same time, complications such as acute lung injury and abnormal coagulation function caused by large-scale repeated blood transfusions significantly increased the maternal mortality rate. The perioperative management of pernicious placenta previa should be considered from the overall perspective of the operation, including the time of termination of pregnancy, surgical plan and choice of anesthesia method, handling of special circumstances during surgery, prevention and treatment of postoperative complications, etc., to ensure the success of the operation.

2. What is placenta previa?

1. Placenta previa is defined as a condition in which the placenta attaches to the lower part of the uterus after 28 weeks of pregnancy, and the lower edge of the placenta reaches or covers the internal cervical os, and then the position of the placenta is lower than the presenting part of the fetus.

2. Depending on the degree to which the lower edge of the placenta covers the internal os of the cervix, placenta previa can be divided into three types: complete placenta previa, partial placenta previa and marginal placenta previa. Among these three types of placenta previa, complete placenta previa is the most harmful to pregnant women and fetuses.

3. The more typical symptom of placenta previa is sudden, painless vaginal bleeding without obvious cause. The time of vaginal bleeding, the number of recurrences, and the amount of bleeding are all related to the type of placenta previa.

3. Common causes of placenta previa

1. Endometrial lesions and damage: Pregnant women have experienced multiple miscarriages, curettage, childbirth, cesarean section and postpartum infection. These behaviors may more or less lead to endometrial damage. More serious cases may even leave scars, causing endometrial inflammation and endometrial atrophy. When a pregnant woman wants to have a second or third baby, her uterine decidua blood vessels do not grow well and the required nutrition is insufficient, which will cause the placenta to slowly stretch to the lower part of the uterus in order to get enough nutrition, and grow and develop there, thus forming a placenta previa.

2. The placenta is too large: When a pregnant woman is carrying twins, multiple babies, or the fetus in her belly is too large, the large placenta formed will extend to the lower part of the uterus or cover the internal opening of the cervix.

3. Trophoblastic stunting: When the fertilized egg reaches the uterine cavity, it continues to migrate into the lower part of the uterus because the trophoblastic stunting does not meet the conditions required for implantation, where it develops and grows to form a placenta previa.

4. The hazards of placenta previa

1. Effects on pregnant women

(1) Placenta accreta: When the decidua of the lower uterine segment of a parturient is underdeveloped, the villi of the placenta will penetrate the decidua basalis, invade the myometrium, and continue to grow and develop, thus forming a placenta accreta. This situation will make the placenta more susceptible to incomplete placental separation, thereby causing postpartum hemorrhage.

(2) Bleeding during and after delivery: When a cesarean section is performed on a placenta attached to the anterior wall of the uterus, if the uterine incision cannot avoid the placenta, there will be a significant increase in bleeding.

2. Effects on the fetus

(1) When bleeding occurs alone or the amount of bleeding is too much at one time, the fetus cannot obtain the required oxygen from the blood, which may cause the fetus to suffer from hypoxia in the mother's uterus, resulting in intrauterine distress, and more seriously, intrauterine fetal death.

(2) The mortality rate of premature infants and neonates is higher than normal.