PLACENTA PREVIA Lin Qi De
PLACENTA PREVIA Lin Qi De
Definition Placenta previa: Abnormal location of the placenta over or in close proximity to the internal os Incidence: approximately 1 /250 pregnancy **: nulliparas: 1 /1000 1/1500 pregnancy d: grandmultiparas: 1/20
Definition Placenta previa: Abnormal location of the placenta over ,or in close proximity to the internal os. Incidence: approximately 1 /250 pregnancy nulliparas: 1/1000~1/1500 pregnancy grandmultiparas: 1/20
Classification Complete(total) placenta previa: entire cervical os is covered Partial placenta previa: the margin of the placenta extends across but not all of the internal oS Marginal: edge of the placenta lies adjacent to the internal os Low lying placenta: placenta is located near but not directly adjacent to the internal OS
Classification Complete (total) placenta previa: entire cervical os is covered Partial placenta previa:the margin of the placenta extends across but not all of the internal os. Marginal:edge of the placenta lies adjacent to the internal os Low lying placenta:placenta is located near but not directly adjacent to the internal os
Etiology Mechanism: abnormal vascularization Predisposing factors: .Twin pregnancy increasing maternal age iNcreasing parity Previous cesarean section
Etiology Mechanism: abnormal vascularization Predisposing factors: •Twin pregnancy •Increasing maternal age •Increasing parity •Previous cesarean section
diagnosis Painless vaginal bleed first bleeding episode is 29N30 weeks Ultrasonography benefit in localizing the placenta and diagnosis placenta previa
diagnosis Painless vaginal bleed: first bleeding episode is 29~30 weeks Ultrasonography: benefit in localizing the placenta and diagnosis placenta previa
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
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
Management Basic management iNitial hospitalization with hemodynamic stabilization ● nforced bed rest Restrictions of activity
Management Basic management •Initial hospitalization with hemodynamic stabilization •Enforced bed rest •Restrictions of activity
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
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
Indication of vaginal delivery o Delivery can be accomplished with minimal blood loss Fetus is dead Major fetal malformation
Indication of vaginal delivery •Delivery can be accomplished with minimal blood loss •Fetus is dead •Major fetal malformation
Complication pLacenta previa accreta postpartum hemophage iNcreasing maternal mortality and perinatal mortality
Complication •Placenta previa accreta •Postpartum hemopphage •Increasing maternal mortality and perinatal mortality