PLACENTA PREVIA

1
PLACENTA PREVIA

• Lin Qi De

2
Definition
Placenta previa Abnormal location of the
placenta over ,or in close proximity to the
internal os. Incidence approximately 1 /250
pregnancy nulliparas 1/10001/1500
pregnancy grandmultiparas 1/20
3
Classification
Complete (total) placenta previa entire cervical
os is covered Partial placenta previathe margin
of the placenta extends across but not all of the
internal os. Marginaledge of the placenta lies
adjacent to the internal os Low lying
placentaplacenta is located near but not
directly adjacent to the internal os.
4
Etiology

• Mechanism abnormal vascularization
• Predisposing factors
• Twin pregnancy
• Increasing maternal age
• Increasing parity
• Previous cesarean section

5
diagnosis
Painless vaginal bleed first bleeding
episode is 2930 weeks Ultrasonography
benefit in localizing the placenta and diagnosis
placenta previa
6
Caution
Double setup vaginal examination No digital
vaginal or rectal examination is preformed in
case of placenta previa . Only as a final and
definitive event and only under conditions of
double set up. This procedure involves
careful evaluation of the cervix in the operation
room with full preparations for rapid cesarean
section.
7

• Management
• Basic management
• Initial hospitalization with hemodynamic
  stabilization
• Enforced bed rest
• Restrictions of activity

8

• Expectant management
• (allow for further fetal growth and maturation)
• Blood transfusion is given as necessary
• Amniocentesis for fetal lung maturity testing
• Cesarean birth if fetus is thought to be mature

9

• Indication of vaginal delivery
• Delivery can be accomplished with minimal blood
  loss
• Fetus is dead
• Major fetal malformation

10
Complication

• Placenta previa accreta
• Postpartum hemopphage
• Increasing maternal mortality and perinatal
  mortality