Placenta Praevia Flashcards
What is placenta praevia?
Placenta overlying the cervical OS
What position can the placenta be in in Placenta praevia?
It can be lying wholly or partly over the lower uterine segment
What is the main presentation of placenta praevia?
Painless bright red vaginal bleeding
When does placenta praevia usually occur?
24 weeks gestation
What is the shock in placenta praevia proportional to?
Visible blood loss
What may be abnormal about the foetus is placenta praevia?
The lie and presentation of the foetus
What is the main investigation of placenta praevia?
Transvaginal ultrasound
When is placenta praevia usually picked up?
20 weeks abdominal ultrasound scan
Why would you do another ultrasound at 37 weeks in a patient with placenta praevia?
To reassess the position of the placenta
How is the position of the placenta classified?
Via a grading scale
What is Grade 1 of Placenta praevia?
Placenta reaches the lower segment but not the internal OS
What is Grade 2 of Placenta praevia?
Placenta reaches the internal OS but doesn’t cover it
What is Grade 3 of Placenta Praevia?
Placenta covers the internal OS before dilatation but not when dilated
What is Grade 4 of Placenta Praevia?
Placenta completely covers the internal OS
What is the management if the patient is grade 3 or 4?
Elective caesarean section (37-38 weeks)
What is the management if the patient is Grade 1?
Vaginal delivery
What is the management of a patient with placenta praevia and bleeding?
Emergency Caesarean section
What are the associated risks with placenta praevia?
- multiparity
- multiple pregnancy
- embryos are more likely to implant on a lower segment scar from previous caesarean section
What are the possible complications of placenta praevia?
- antepartum haemorrhage
- emergency caesarean section
- emergency hysterectomy
- maternal anaemia and transfusions
- preterm birth and low birth weight
- stillbirth
