Placenta Praevia Flashcards
What is placenta praevia?
Placenta praevia occurs when the placenta partially or completely covers the internal cervical os.
What are the types of placenta praevia?
Types include major placenta praevia (completely covers the os) and minor placenta praevia (partially covers or is near the os).
What is the prevalence of placenta praevia?
It occurs in approximately 1 in 200 pregnancies at term.
What are the risk factors for placenta praevia?
Risk factors include previous caesarean section, multiple pregnancies, advanced maternal age, smoking, and uterine surgery.
How is placenta praevia diagnosed?
Diagnosis is made using transabdominal or transvaginal ultrasound to locate the position of the placenta relative to the cervix.
What are the clinical features of placenta praevia?
Features include painless vaginal bleeding, often in the third trimester, and a soft, non-tender uterus.
How does placenta praevia differ from placental abruption?
Placenta praevia causes painless bleeding, while placental abruption is associated with painful bleeding and uterine tenderness.
What are the complications of placenta praevia for the mother?
Complications include haemorrhage, need for blood transfusion, hysterectomy, and maternal death in severe cases.
What are the complications of placenta praevia for the fetus?
Complications include preterm birth, intrauterine growth restriction (IUGR), and stillbirth.
What is the initial management of bleeding in placenta praevia?
Management includes stabilising the mother, monitoring the fetus, and preparing for emergency delivery if necessary.
What is the role of ultrasound in placenta praevia?
Ultrasound determines the placental location and excludes other causes of bleeding.
What is the recommended management for asymptomatic placenta praevia?
Management involves regular ultrasound monitoring, avoiding vaginal examinations, and planning delivery at a suitable gestational age.
What is the significance of placenta praevia in labour?
Placenta praevia increases the risk of catastrophic bleeding during labour, often requiring caesarean delivery.
When is delivery planned in placenta praevia?
Delivery is usually planned at 36-37 weeks via caesarean section to avoid the risks associated with labour.
What precautions should be taken during delivery in placenta praevia?
Delivery requires a multidisciplinary team, blood products availability, and anaesthetic support for potential complications.
What is placenta accreta, and how is it related to placenta praevia?
Placenta accreta occurs when the placenta abnormally attaches to the uterine wall, often associated with placenta praevia and previous caesarean sections.
How is severe bleeding in placenta praevia managed?
Severe bleeding is managed with resuscitation, blood transfusion, uterotonic agents, and emergency caesarean section.
What are the long-term risks after placenta praevia?
Long-term risks include increased risk of recurrence in subsequent pregnancies and placenta accreta spectrum disorders.
How can placenta praevia be prevented?
Prevention involves minimising modifiable risk factors, such as avoiding smoking and reducing unnecessary uterine surgery.
What are the recommendations for antenatal care in women with placenta praevia?
Recommendations include close monitoring, avoiding sexual intercourse and heavy activity, and ensuring access to emergency care.
What is the role of corticosteroids in placenta praevia?
Corticosteroids are given to promote fetal lung maturity if early delivery is anticipated.
How is minor placenta praevia managed differently from major placenta praevia?
Minor cases may resolve as the pregnancy progresses, while major cases often require planned caesarean delivery.
What is the prognosis for placenta praevia?
With appropriate management, most cases result in good maternal and fetal outcomes, but severe cases carry risks of significant morbidity.
What is the role of MRI in placenta praevia?
MRI may be used to assess for placenta accreta and guide delivery planning in complex cases.
How does smoking increase the risk of placenta praevia?
Smoking reduces placental perfusion, increasing the likelihood of abnormal placental implantation.
What are the psychological impacts of placenta praevia on pregnant women?
Psychological impacts include anxiety, fear of complications, and stress due to hospitalisation or planned preterm delivery.
