Placenta Previa

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Placenta Previa

• Ob Gy Department, First Hospital, Xian Jiao
  Tong University
• SHU WANG

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Definition

• This is where a placenta is inserted partially or
  wholly in the lower uterine segment.
• pictures

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placenta Previa
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placenta Previa
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Etiology

• Endometrium disorder and injury
• Massive placenta
• Abnormal placenta
• Germ cell with delay of trophblast developing

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Classification

• Complete placenta previa
• Partial placenta previa
• Marginal placenta previa

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Clinical presentation

• Manifestation
• It characteristically presents with
  unprovoked and repeated painless vaginal
  bleeding.

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Manifestation

• The classification of previa placenta
  sometimes determines the occurrence period and
  the volume of losing blood.

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symptom

• Severe blood losing leads to several
  shock signs ,such as paleness ,weak and quick
  pulse and hypotension.
• Malpresentation maybe exists,and
  floating presentation could be found during late
  gestational weeks.

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Diagnosis

• History
• Symptom
• Vaginal examination
• Ultrasonography
• Placenta and membrane examination after delivery

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Differentiation diagnosis

• Placental abruption
• vessel Previa
• Cervical polypus
• Cervical erosion
• Cervical carcinoma

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Risk

• Postpartum haemorrhage
• Implanted placenta
• Postpartum infection
• Amnion fluid embolism
• Premature delivery and increasing perinatal
  mortality

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Treatment

• Expectant delivery
• aim at achieving amixmum fetal maturity
  possible while minimizing the risk to both
  mother and fetus.

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Expectant delivery

• The method apply to the patient with
  small and self-limited bleeding ,and without
  fatal risk either to fetus or mother.

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Immediate delivery

• Indications
• When the bleeding is profuse and life is
  threatening , no matter the fetus is mature or
  unmature ,alive or dead.
• If bleeding continues but is neither profuse nor
  life threatening and the gestation is more than
  34 weeks.

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• Method
• cesarean section
• Transvaginal delivery
• Emergency managment