Q : Can placenta abruption and placenta previa be caused by me?
A : Placental abruption occurs when the placenta separates from the wall of the uterus before the baby is born. Placenta previa occurs when the placenta is very close to or covers the opening of the cervix. If you have a previous history of abruption, elevated blood pressure, uterine abnormalities (like, fibroids), inherited or acquired clotting tendency (thrombophilia), are carrying twins or higher order gestation or increased parity (previous number of pregnancies), the risk for abruption is greater.
The risk also increases with maternal age, as well as for women who are smokers or use cocaine. Risk factors for placenta previa include some of the same risk factors as placental abruption: increased parity, increased maternal age and cigarette smoking. In addition, women who have a history of previa, live at higher elevations or have had a previous C-Section are at a greater risk.
Of course, the easiest way to prevent abruption is to avoid smoking and cocaine use. Also, you’ll want to make sure your doctor or provider is aware of any inherited thrombophilias and uterine abnormalities. The only risk factors for previa which are preventable include smoking and living at higher altitudes. Avoiding elective Cesarean delivery may also decrease your risk for previa, especially if you are planning on having more than two babies.
Q : What do preeclampsia symptoms mean and what can I do?
A : Preeclampsia, which affects approximately 6-8% of first-time pregnancies, is defined as high blood pressure and protein in the urine after the 20th week of pregnancy. While there are many theories on preeclampsia, we don’t know its exact cause. Risk factors include first pregnancy, family history of preeclampsia, preeclampsia in previous pregnancy, obesity, twins or higher order gestation and medical conditions complicating pregnancy (such as, high blood pressure, diabetes or kidney disease).
It is also more common in very young and older mothers. In addition to elevated blood pressure and protein in the urine, signs and symptoms of preeclampsia may include headache, abdominal pain, changes in vision (spots or flashes of light) and significant swelling. Headache and vision changes are associated with the increased blood pressure. Increased protein in the urine is caused by spasms of the blood vessels in the kidney, which, is also associated with increased blood pressure. Abdominal pain may indicate that the liver has been affected by preeclampsia. Swelling is also caused by changes which occur in the blood vessels.
It is important to note, however, that swelling (edema) is very common in uncomplicated pregnancy and so, edema is not a criterion for preeclampsia. Studies have examined ways to prevent preeclampsia, but there is currently no known cure. Preeclampsia, however, is a serious complication of pregnancy, and your doctor may recommend hospitalization, bed rest, blood pressure medications and testing of the fetus for signs of distress.
Q : When should I call the doctor if I am worried?
A : You should typically contact your care provider if you experience vaginal bleeding, severe abdominal pain, pre-term contractions, severe headache, changes in your vision or significant swelling.
Dr. Wick is a practicing board-certified OB/GYN at Mayo Clinic in Rochester, Minnesota. She attended Mayo Graduate School and Mayo Medical School, where she earned both a Ph.D and an M.D.
Dr. Wick is certified by the American Board of Obstetrics and Gynecology and the American Board of Medical Genetics. Her professional interests include prenatal genetics, the genetics of congenital cardiac disease and the long-term effects of maternal obesity. In addition to her professional experience, Dr. Wick is the proud mother of four children.
Dr. Wick is the author of the Mayo Clinic Guide to a Healthy Pregnancy.