Low-lying placenta (placenta praevia)

The placenta is your baby’s support system in the womb. If the placenta doesn’t work properly, your baby is at risk of health problems.

The placenta processes your baby’s nutrients, waste and oxygen. 

In most pregnancies the placenta attaches to the side of the womb but for some women the placenta attaches lower down and may cover a part or all of the cervix (entrance to the womb). This is called low-lying placenta or placenta praevia.

This often shows up in early ultrasound scans when it is called low-lying placenta. In 90% of cases, the placenta moves upwards as the womb grows. For some women, however, the placenta continues to lie in the lower part of the uterus after 20 weeks. This affects 1 in 200 births.

When this happens it is called placenta praevia. If the placenta covers the cervix, this is known as major placenta praevia.

A note on the difference between placenta praevia and anterior placenta

People sometimes think that low-lying placenta is linked to having an anterior placenta but this is not correct. Anterior placenta simply means the placenta is on the front (belly side) of the womb rather than attached to the back of the womb. Having an anterior placenta is normal and does not cause complications. 

How would I know if I had placenta praevia?

Placenta praevia is usually spotted during your normal ultrasound scans but other signs are:

  • painless vaginal bleeding in the second or third trimester
  • baby in an unusual position in the second or third trimester, breech for example or failure of the head to engage in the pelvis just before labour starts.

If you have any bleeding, contractions or pain in pregnancy you should always contact the hospital.

You may have a transvaginal scan (where the probe is placed inside the vagina) to confirm whether you have placenta praevia.

The risk factors for placenta praevia

In many cases the cause of placenta praevia is unknown but the following risk factors are associated with the condition:

Treatment for placenta praevia

You will have extra scans if you are found to have a low-lying placenta in a routine scan.

An extra scan is recommended at 32 weeks if:

  • you had a caesarean section before
  • your placenta covers the cervix (major placenta praevia)
  • your placenta is in an anterior position (at the front of the womb) and you have had a previous caesarean section.

If your placenta does not cover the cervix and you have no bleeding during your pregnancy, your extra scan should happen around 36 weeks instead. 

There is a risk that you may bleed in the second half of pregnancy (sometimes caused by having sex). Bleeding from placenta praevia can be heavy. If you bleed contact your hospital immediately.

If you have major placenta praevia (the placenta covers the cervix) you may need to stay in hospital after 34 weeks of pregnancy even if you have had no symptoms. There is a small risk that you could bleed suddenly and severely, which may mean that you need an urgent caesarean section. If you are bleeding the baby may need to be delivered.

Placenta praevia is linked to spontaneous preterm delivery and PPROM (waters breaking early), a major cause of premature labour.

The birth

Your obstetrician and / or midwife is likely recommend delivery in hospital, rather than a home setting, and caesarean section might be considered the safest option if the placenta is less than 2cm away from the internal os (the part of the cervix that opens into the uterus).

If you have major placenta praevia (where it covers the cervix) or if the placenta is very close to the cervix you will need to have a caesarean section because the placenta lies in the way of your baby being born.

Sources

  1. RCOG (2011) Information for you: A low-lying placenta (placenta praevia) after 20 weeks, Royal College of Obstetricians and Gynaecologists
  2. RCOG (2011) Placenta praevia, placenta praevia accreta and vasa praevia: diagnosis and management, Green-top Guideline No 27, Royal College of Obstetricians and Gynaecologists
  3. BMJ Best Practice (accessed Oct 2016) http://bestpractice.bmj.com/best-practice/monograph/667/diagnosis/history-and-examination.html
  4. BMJ Best Practice (accessed Oct 2016) http://bestpractice.bmj.com/best-practice/monograph/667/basics/aetiology.html
  5. J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
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    Last reviewed on September 12th, 2016. Next review date September 12th, 2019.

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    Comments

    Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
    • By Eva (not verified) on 19 Apr 2020 - 09:15

      Im currently 16 weeks + 6 days. I had a heavy bleed recently and went to dr. Had ultra sound and they said I have a low lying placenta. I've been spotting a tiny bit since. Is it going to be normal to bleed? When should I be concerned? Will it stop? My appt was on a Friday at 11 am I received my results over phone 10 minutes before my dr closed. As im looking things up I have questions and concerns but its the weekend so cannot call dr office. I was just told to not have sex and dont put anything up there and to follow up in 3 weeks for another ultra sound.

    • By Dee (not verified) on 12 Apr 2020 - 20:22

      Im 16 weeks with low lying placenta. Ive been in hospital twice this past 2 weeks. Ive been bleeding and clots for 4 days now. Saw the Gynie 4 days ago and he keeps on telling me its old blood. Its my first pregnancy and im older than 35. I dont know what to do anymore. Each time I went to the hospital they meds stopped the bleeding but when I get home and especially after a hot shower the bleeding gets worse. Are my baby in danger. What does the clots mean?

    • By Mary (not verified) on 16 Mar 2020 - 19:00

      January 3 I diagonised with low lying placenta n I was 24 weeks I had bleeding MI doctor MI doctor say I bed rest n no sex. N on 15 January the bleeding was heavy n they perform emergency c section ni was 26 n I lost MI baby boy after some few hours I'm heart broken. How to correct placenta previa

    • By MP (not verified) on 12 Mar 2020 - 16:30

      Hi, i had my 20 weeks scan and was told that my placenta is 1.5 cm from cervix. Been told that it should be further than 1cm away. So it was written placenta posterior high in the notes. And no further advice or info. I am very confused. Has the criteria changed? Or is it just local criteria in my hospital?

    • By Bella (not verified) on 23 Mar 2020 - 14:28

      I’m from Ontario and was told it should be minimum 2cm or more away.

    • By Rossie (not verified) on 28 Feb 2020 - 23:55

      I am 31 weeks and was told I have a low lying placenta. But lately been having brown discharge.

    • By saba (not verified) on 6 Feb 2020 - 08:53

      i have pain in my uterus due to this my doctor told me to do bed rest plz suggest me what to do

    • By Ornela (not verified) on 7 Jan 2020 - 18:42

      Hello, I have been diagnosed today at 16 week and 5 days with placenta preavia due to transvaginal scan. My doctor set an appointment after 1 month..is there any chance for placenta to move on, what should I do during this time..I am a dentist? Is my work harmful for me and my baby? Should I stay in bed, I havent notice bleeding untill now and I have had sex butof course it will stop now.I am very worried, I have been all day reading about this..looking forward for your answer

    • By Dp (not verified) on 21 Jan 2020 - 13:15

      Placenta previa is to be taken seriously but these days very common in women. If its bleeding please do visit your doctor and may be rest. I have seen colleagues who attended work with placenta previa . Dont worry at all; it moves up in it own in most of the cases. Eat well, rest well and if there is no bleeding continue to work but dont exert.

    • By Clrkrk (not verified) on 21 Jan 2020 - 19:54

      I have been diagnosed with placenta previa (complete) at my 20 week scan. I am now 25+5 and have just been in hospital over night due to spotting.
      Docs/midwifes were great. Scan confirmed a bleed in the placenta. Spotting stopped and I have been sent home to rest but not complete bed rest.
      Have another scan to check all is well in a couple of weeks.
      If you have similar then the best advice I have been given is -
      No sex (or anything that can bring on an orgasm).
      No lifting above 20lbs.
      No over reaching or stretching.
      No exerting exercise (walking is fine).
      Keep hydrated, eat well and stay positive.

    • By Clrkrk (not verified) on 21 Jan 2020 - 19:57

      I have been diagnosed with placenta previa (complete) at my 20 week scan. I am now 25+5 and have just been in hospital over night due to spotting.
      Docs/midwifes were great. Scan confirmed a bleed in the placenta. Spotting stopped and I have been sent home to rest but not complete bed rest.
      Have another scan to check all is well in a couple of weeks.
      If you have similar then the best advice I have been given is -
      No sex (or anything that can bring on an orgasm).
      No lifting above 20lbs.
      No over reaching or stretching.
      No exerting exercise (walking is fine).
      Keep hydrated, eat well and stay positive.

    • By Sandhiya (not verified) on 21 Dec 2019 - 08:47

      I have placenta previa type 3 at 30 weeks. This is my second baby. First one is c section. After 5 daya took treatment in hospital now i am taking bed rest in home. I didn't have bleeding now. At 36 years old, i taken bed rest at home or need to admit hospital. please suggest

    • By Midwife @Tommys on 23 Dec 2019 - 16:08

      I would suggest you contact your own midwife or hospital doctor to advise you on this. If you have any bleeding or other pregnancy concerns then please ring your maternity unit labour ward immediately.

    • By Anonymous (not verified) on 18 Dec 2019 - 01:23

      Hi I'm 12 weeks pregnant I started to bleed when I was 6weeks pregnant it lasted for 3days visited the dr he told me I need to rest now I'm 12 weeks and I'm bleeding and passing clot was admitted to the hospital for 5days and the dr told me I have low laying placenta and I have to me very careful and take strict bed rest and you say if it's safe for me and the baby

    • By Miracle Samuel (not verified) on 15 Dec 2019 - 13:59

      Went to scan at 25 weeks and the result says that my placenta is Postero - fundally sited and not low lying, please what do they mean by that, should I worry or not.

    • By Midwife @Tommys on 16 Dec 2019 - 15:07

      Hi, This is completely normal and nothing to worry about. Enjoy your pregnancy.

    • By Ellen Roberts (not verified) on 19 Dec 2019 - 11:09

      A postero-fundal placenta means that the placenta is at the top and back of the uterus. This is a normal and healthy place for your placenta to be sited and is not worrying at all. Congratulations.

    • By Cindy (not verified) on 27 Nov 2019 - 02:47

      In my 20 wks doctor told i have low plecenta and 2cm from cervix but no bledding he just told me no sex, and no heavy stuff i just wondering if will be move upper? But my baby he so active.

    • By Janeth (not verified) on 23 Nov 2019 - 01:01

      At 28 weeks, do you think it will still improve or move up? Or is there any chance thatnit will go lower? Thankyou

    • By Hi (not verified) on 6 Nov 2019 - 05:11

      Can anyone tell me what exactly is it .bcs its my first baby im scared , doctor said that you have to take rest .

    • By Bhagyashree (not verified) on 10 Oct 2019 - 14:13

      In 32nd week, done sonograpgy, report says lower end of placenta is 3.2 cm from the internal os.

      Is it dangerous?

      Please guide someone

    • By Deepthi (not verified) on 3 Dec 2019 - 17:54

      Anything above 2 cm is not a risk dear.don't worry

    • By Vv Priya (not verified) on 5 Sep 2019 - 09:06

      Hi.. Am 14weeks pregnant. It's my 2nd baby. First is boy and normal delivery. While scanning doctor said, Placenta anterior close to internal os. And said may baby move up while weight gains. But not sure. Will wait for 5th month. What is it mean? What is the complexities?

    • By Anonymous (not verified) on 8 Jan 2020 - 06:31

      Exactly the same thing with me. Can any one reply on this

    • By Zanna (not verified) on 17 Jul 2019 - 18:35

      my wife is 26 wks and having placenta lowlying what can we do now

    • By Nelly (not verified) on 8 Jul 2019 - 16:58

      I had an anomaly scan today and i'm 22weeks gone.The doctor conducted a scan on me and was told that i have a low-lying placenta.Pls i want to know if the placenta will move up later and if there's a risk involved because i'm not bleeding

    • By Petra O rourke (not verified) on 2 Aug 2019 - 21:03

      I have low lying placenta too doc said to me not to worry it should move as baby gets bigger!

    • By Divya (not verified) on 8 Jul 2019 - 12:29

      Hello Ma'am,
      Now I'm 20 weeks 2 days pregnant. When I had my anomaly scan at 15.6 weeks, it showed that I have anterior low lying placenta and placental venous lake seen overlying internal os which is covering the cervix. It's my second pregnancy My Gynecologist told me it is very risky for me n my baby. She also told me for strict bed rest.If my placenta doesn't move upwards, is it possible to have a vaginal delivery

    • By Sarin Mythry (not verified) on 15 May 2019 - 18:27

      Hi my wife is now almost 20 weeks pregnant. Last week she had heavy bleeding and even 2 big clots was passed. Doctors say , since placenta has moved high from low lying point, due friction in motion of placenta , bleeding took place, and there is some collection of blood about 3cm in area near placenta. Doctor also told , there might be another episode of bleeding due to blood collection near placenta or it might get subside. Even now my wife is having light bleeding. Can anyone suggest me, am worried. Is it harmful to baby and growth and also to my wife. And can this happen in low lying placenta and still they go on safely to deliver baby after this pregnancy phase even with this bleeding without pain.

    • By parami (not verified) on 15 May 2019 - 10:30

      I had taken anamoly scan during 18 weeks of pregnancy. The report says that iam having type ii low lying posterior placenta previa touching the internal os. My doctor advised me to put maintane 500 injection up to 8th month. Will it possible for vaginal delivery or it will end with C-section. Plz reply mam

    • By Heena (not verified) on 14 May 2019 - 01:27

      Sir i m 18 week pregnantand my placanta is lower end away from os is only 3 cm.. I m very scread is it all ok or not plz tell me

    • By Manju Kubendran (not verified) on 13 May 2019 - 11:46

      Hi.. This is my 2nd pregnancy . First girl baby is normal.Am now 34 weeks pregnant placenta posterior and low lying 1.4 cms away from OS .. Normal delivery is possible

    • By Manju Kubendran (not verified) on 13 May 2019 - 11:45

      Hi.. This is my 2nd pregnancy . First girl baby is normal.Am now 34 weeks pregnant placenta posterior and low lying 1.4 cms away from OS .. Normal delivery is possible

    • By Test (not verified) on 12 Jan 2020 - 18:19

      hey dont worry it will move. my case was oppo mine identified low lying on 20 weeks and in 32 and 36 week no change 1.4 cm distance to cervical os so elective c section is scheduled in 38 weeks

    • By Siobhan (not verified) on 10 May 2019 - 21:40

      Hi I have just had my scan in currently 36 weeks at my 32 week appointment I was told it was 1cm away from os but my 36 week one said it was 0.7cm away does this mean it has moved closer to my cervix

    • By Siobhan (not verified) on 10 May 2019 - 21:39

      Hi I have just had my scan in currently 36 weeks at my 32 week appointment I was told it was 1cm away from os but my 36 week one said it was 0.7cm away does this mean it has moved closer to my cervix

    • By Nadia (not verified) on 6 May 2019 - 11:43

      Hi,
      I am 33 weeks pregnant and been told that placenta is completely lying on OS. I found out at 20 weeks scan that I have low lying placenta but it still there at 33 weeks.
      I am going for another scan at 36 weeks.
      I don’t know what risks it will bring and what I should be doing and is there any chances it will move up itself at this stage?
      Thanks

    • By Kirti (not verified) on 29 May 2019 - 03:42

      what u did precautions at that stage.i m in same boat.i m at 30 weeks pregnancy and placenta cover the is.help me plz

    • By Nadia (not verified) on 4 May 2019 - 19:24

      Hi,
      I am 33 weeks pregnant and was told last week that placenta is totally covering my cervix which hasn’t moved since 20 weeks when I first found out. I wanted to know is there still chances of placenta to move by 36 weeks?
      And I am not having any bleeding or anything so just curios how serious it is and am I still going to have a C section?
      Thanks

    • By Dolly (not verified) on 28 Apr 2019 - 06:05

      Im on my 28 week of pregnancy... last day scan show placenta is grade 1 n lower edge is 2 cm from internal os.. 20 week scan also shows the same previous.. but now doctor told me to do conplete bed rest.. so there is chances that placenta will come upwards??? Or wl i complete my 36 weeks for a safe delivery???

    • By Fajila (not verified) on 19 Jun 2019 - 06:47

      Same problem me.im in 22 weeks my ultrasound report show that anterior low lying placenta margin 2.0 from internal os if it is risk from baby plz tell me.. R u delivered normal or c section.what happened to you plz tell me

    • By Joyce Sam (not verified) on 3 Apr 2020 - 19:30

      I went for scan on 19 weeks and the scan showed that my placenta is low so am so worried

      Please someone should help me

    • By Louise (not verified) on 27 Apr 2019 - 13:36

      Hello, I woke this morning to bleeding when I wiped. Very scary. Went to EPAU and thankfully the baby is fine on the scan. They noticed the placenta is low lying and believe this to be the cause of bleeding.

      They said its not covering the cervix. Can someone tell me how the low lying placenta can cause bleeding?

      Thanks so much

      Louise

    • By Emma Wolfe (not verified) on 26 Apr 2019 - 08:29

      Hi at my anamoly scan the tech I dentified that my placenta covers my cervix and placenta could be seen on both posterior and anterior walls. He also raised concern that some blood vessels could be seen travelling under the baby. From what I can research thus is possible placenta previa with previa vasa. What does this mean for me and my baby. This is baby no 5 all previous normal healthy delivery of large babies. I'm really stressing myself out with worry.

    • By Mary (not verified) on 26 Apr 2019 - 06:18

      At my last ultrasound at 35+2 my placenta was still lying low at 1.7cm away from the uterus. Do you think I could move or be safe to deliver vaginal. The doctor seem confused of what to do. He kind say it was up to me but I want to do what's best for my baby and me.

    • By Salma (not verified) on 25 Apr 2019 - 06:24

      I have anterior low lying placenta at 15 weeks pregnancy with mild spotting whenever I go to the toilet.is there any chance it will move up?

    • By Midwife @Tommys on 25 Apr 2019 - 13:02

      Hi - Thank you for your message.
      A low lying placenta can move up and away from the cervix as the uterus grows. if you have look at the clip on the page above it is explained in detail.
      Sorry to hear that you have been having a difficult time in this pregnancy. Having a low lying placenta can mean that bleeding can happen in pregnancy, its just very important that each time you do bleed you go into hospital even if its happens regularly and everything is ok.
      Best wishes
      Tommy's midwife

    • By Iqu sik (not verified) on 7 May 2019 - 11:39

      I have same issue and my belly will so hard when go for sleep feeling so pain in stomach only sleep straight no right side no left side,now i'm in 19 weeks can it's possible if placenta low lying im giving brith normal?or its must surgery?

    • By Abbie (not verified) on 12 Apr 2019 - 19:37

      Hi, I’m 24 weeks today and was told at my 20 week scan that my placenta is completely covering the OS. There have been talks of a C section and my midwife says the chances of a placenta completely covering to move is slim. I’ve had some bleeding and been checked but am very nervous about early birth etc. Has anyone had any experience with this and it moving? Thankyou x

    • By Midwife @Tommys on 24 Apr 2019 - 10:13

      Hi
      You should have been booked for a repeat scan at 32 weeks to assess if the placenta has moved away from the os as the lower segment of the uterus develops.
      If the placenta remains in the same position then delivery will be Caesrean Section-the timing of this will be discussed by your obstetrician.

      There is a risk that you may bleed in the second half of pregnancy (sometimes caused by having sex). Bleeding from placenta praevia can be heavy. If you bleed contact your hospital immediately.

      If you have major placenta praevia (the placenta covers the cervix) you may need to stay in hospital after 34 weeks of pregnancy even if you have had no symptoms. There is a small risk that you could bleed suddenly and severely, which may mean that you need an urgent caesarean section. If you are bleeding the baby may need to be delivered.
      Take care
      Tommys' midwife

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