Chapter 12AntepartumHemorrhage
Chapter 12 AntepartumHemorrhage
一.Placenta PreviaDefinition:After28 pregnant weeksplacentalimplantation over the cervical os or inthe lower uterine segment
一 . Placenta Previa Definition ： After 28 pregnant weeks placental implantation over the cervical os or in the lower uterine segment
Etiology : The cause of placentaprevia remains unclear. but possi-ble etiologic factors.as1,poorlyvascularizedendometrium2、largeplacenta.3Abnormalplacenta4,placentaimplantedin theloweruterine segment
Etiology ： The cause of placenta previa remains unclear . but possible etiologic factors. as 1、poorly vascularized endometrium. 2、large placenta. 3、Abnormal placenta 4、placenta implanted in the lower uterine segment
Classification1、 cmplete placenta previa.2、partialplacenta previa3、marginal placenta previa
Classification 1、cmplete placenta previa. 2、partial placenta previa 3、marginal placenta previa
Clinical manifeslation1、symptoms:sudden painless vaginalbleeding ,bleeding results fromdetachment of placental tissueas the lower uterine lengthensand the subsequent Inability
Clinical manifeslation 1、symptoms： sudden painless vaginal bleeding ,bleeding results from detachment of placental tissue as the lower uterine lengthens and the subsequent Inability
of the lower segment to contract,vessels contrict to stop the bleeding o2、 signs: uterus usually is soft andnontender,the fetal presentingpart is not into the pelvic inlet
of the lower segment to contract , vessels contrict to stop the bleeding 。 2、signs: uterus usually is soft and nontender , the fetal presenting part is not into the pelvic inlet
Diagnosis1、History,After28pregnantweeks, sudden painlessintermittent vaginal bleeding .2、 Sings, anaemia or shock.3,Vaginal examinationpreparations for transfusionopreration delivery , if thediagnosis of placenta previa
Diagnosis 1、History, After 28 pregnant weeks , sudden painless intermittent vaginal bleeding . 2、Sings , anaemia or shock . 3、Vaginal examination preparations for transfusion opreration delivery , if the diagnosis of placenta previa
is sufficient or profuse vaginalbleeding , the vaginal examina-tion shouldbe omitted.4ultrsound examination.5, examination of the placental andfetalmembraneAfter delivery
is sufficient or profuse vaginal bleeding , the vaginal examination should be omitted . 4、ultrsound examination . 5、examination of the placental and fetalmembrane After delivery
Differential DiagnosisComplications1、postpartumbleeding2、placentaaccreta3、infection4.amnioticfluid embolism
Differential Diagnosis Complications 1、postpartum bleeding 2、placenta accreta 3、infection 4、amniotic fluid embolism
5, prematurity and perinatalfetal deathtreatment1、ExpectantTherapy2, vaginal deliverycesarean section
5、prematurity and perinatal fetal death treatment 1、Expectant Therapy 2、vaginal delivery cesarean section