Antenatal Care - Placenta Praevia Flashcards
What is Placenta Praevia?
The placenta is attached in the lower portion of the uterus, lower than the presenting part of the foetus (going before the foetus).
What is a Low-Lying Placenta?
The placenta is within 20mm of the internal cervical os.
What is the difference between a Low-Lying Placenta and Placenta Praevia?
Placenta Praevia is when the placenta is over the Internal Cervical Os.
Differential Diagnoses of APH.
- Placenta Praevia.
- Placental Abruption.
- Vasa Praevia.
Differential Diagnoses of Minor Bleeding/Spotting in Pregnancy.
- Cervical Ectropion.
- Infection.
- Vaginal Abrasions from Intercourse/Procedure.
Risk Factors of Placenta Praevia (8).
- Previous C-Sections.
- Previous Placenta Praevia.
- Increased Maternal Age.
- Maternal Smoking.
- Structural Uterine Abnormalities.
- Assisted Reproduction (IVF).
- Multiparty.
- Multiple Pregnancy.
Grading System of Placenta Praevia.
Previously based on the placenta’s location in relation to the internal cervical os - no longer recommends by RCOG (I-IV).
Clinical Presentation of Placenta Praevia (2).
- Asymptomatic.
2. Painless Vaginal Bleeding - APH (around Week 36).
Investigations of Placenta Praevia.
- Week 20 Anomaly Scan : Position of Placenta - Diagnosis.
2. Repeat TVUS at Week 32, 34, 36 to guide decisions about delivery.
Management of Placenta Praevia.
- Corticosteroids between 34 and 35+6 weeks.
- Planned Delivery Between 36 and 37 - Planned C-Section.
- Emergency C-Section (Premature Labour or Antenatal Bleeding).
Urgent Management of Placenta Praevia if Haemorrhage Around Delivery (5).
- Emergency C-Secitons.
- Blood Transfusions.
- Intrauterine Balloon Tamponade.
- Uterine Artery Occlusion.
- Emergency Hysterectomy.
Complications of Placenta Praevia (6).
- Antepartum Haemorrhage.
- Emergency C-Section.
- Emergency Hysterectomy.
- Maternal Anaemia (& Transfusions).
- Preterm Birth and Low Birth Weight.
- Stillbirth.
