Placenta Previa

Placenta
Previa
Table of Content
 Introduction
 Definition of Placenta previa
 Pathophysiology
 Cause of Placenta previa
 Risk Factors
 Types
 Signs and Symptoms
 Diagnosis
 Management
 Complications
Introduction
 Placenta previa is the attachment of the
placenta to the wall of the uterus in a location
that completely or partially covers the uterine
outlet (opening of the cervix).
 Bleeding after the 20th week of gestation is the
main symptom of placenta previa.
 An ultrasound examination is used to establish
the diagnosis of placenta previa.
 Cesarean delivery is required for complete
placenta previa.
Placenta Previa
Definition
 Placenta previa is a condition wherein
the placenta of a pregnant woman is
implanted abnormally in the uterus.
 It accounts for the most incidents of
bleeding in the third trimester of
pregnancy.
Pathophysiology
 The placenta implants on the lower part of the
uterus.
 The lower uterine segment separates from the
upper segment as the cervix starts to dilate.
 The placenta is unable to stretch and
accommodate the shape of the cervix, resulting
in bleeding.
Cause
 The cause of placenta previa is
unknown, but it is more common in
women who have a history of uterine
surgeries (cesarean sections, dilation
and curettage), infections with
endometritis, and a previous placenta
previa.
 It is also more common in those women
who currently have a multiple gestation
with a large placenta. Smoking is also a
contributing factor.
Risk Factors
Placenta previa is dangerous if not detected early.
However, it is also highly preventable once you
get to know the risk factors.
 Advanced maternal age. Women who are
over the age of 35 years old are at an
increased risk of developing placenta previa.
 Multiple gestations. The uterus which has
accommodated more than one fetus has an
increased risk for placenta previa.
Risk Factors………
 Increased parity. Women who have given
birth to a lot of children have an increased
chance of having placenta previa.
 Past caesarean births. Giving birth via
caesarean delivery predisposes the woman to
placenta previa on her next childbearing.
 Past uterine curettage. Scars from a past
curettage can affect the implantation of the
uterus and lead to placenta previa.
Types
 LOW-LYING
The placenta implants in the
lower uterine segment but
does not reach the cervical
os; often this type of
placenta previa moves
upward as the pregnancy
progresses, eliminating
bleeding complications later.
Types…..
 MARGINAL
The edge of the placenta is
at the edge of the internal
os; the mother may be able
to deliver vaginally.
Types…..
 PARTIAL
The placenta partially covers
the cervical os;as the
pregnancy progresses and
the cervix begins to efface
and dilate, the bleeding
occurs.
Types…..
 COMPLETE OR TOTAL
The placenta covers the
entire cervical os; usually
requires an emergency
cesarean section.
Signs and Symptoms
The following signs and symptoms for placenta
previa must be detected immediately by the
health care providers to avoid risking the life of
the fetus.
 Bright red bleeding. When the placenta is
unable to stretch to accommodate the shape of
the cervix, bleeding will occur suddenly that
could frighten the woman.
 Painless. Bleeding in placenta previa is not
painless and may also stop as abruptly as it
had begun.
Diagnostic Tests
To diagnose placenta previa, the patient
must undergo the following diagnostic
procedure.
 Ultrasound. Early detection of placenta
previa is always possible through
ultrasonography. It is the most common
and initial diagnostic test that could
confirm the diagnosis.
Medical Management
Medical interventions are necessary to ensure that the
safety of both mother and fetus are still intact.
 Intravenous therapy. This would be prescribed
by the physician to replace the blood that was lost
during bleeding.
 Avoid vaginal examinations. This may initiate
hemorrhage that is fatal for both the mother and
the baby.
 Attach external monitoring equipment. To
monitor the uterine contractions and record fetal
heart sounds, an external equipment is preferred
than the internal monitoring equipment.
Surgical Management
Surgical interventions are carried out once the
condition of both the mother and the fetus has
reached a critical stage and their lives are
exposed to undeniable danger.
 Cesarean delivery. Although the best way to
deliver a baby is through normal delivery, if
the placenta has obstructed more than 30% of
the cervical os it would be hard for the fetus to
get past the placenta through normal delivery.
Cesarean birth is then recommended by the
physician.
Complications
If you have placenta previa, your health care
provider will monitor you and your baby to reduce
the risk of these serious complications:
 Bleeding. Severe, possibly life-threatening
vaginal bleeding (hemorrhage) can occur
during labor, delivery or in the first few hours
after delivery.
 Preterm birth. Severe bleeding may prompt
an emergency C-section before your baby is
full term.
References
 Google.com
 Wikipedia.org
 Studymafia.org
 Slidespanda.com

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