Placenta Praevia

Question 1

What is placenta praevia?

Answer 1

A low lying placenta which overlies the internal cervical OS

Question 2

Risk factors for placenta praevia?

Answer 2

Smoking
IVF
Multiple pregnancy
Increased age
History uterine surgery
history placenta praevia

Question 3

Placenta praevia can be categorised into degree of praevia? (2)

Answer 3

Minor degree

Major degree

Question 4

What are the 4 types of placenta praevia?

Answer 4

Question 5

Answer 5

Type I

(lateral / low lying)

Minor degree

Question 6

Answer 6

Type II

• marginal

Minor degree

Question 7

Answer 7

Type III

(partial)

Major degree

Question 8

Answer 8

Type IV

Complete / central

Major degree

Question 9

What are the symptoms and timeline of placental praevia?

Answer 9

PainLESS Pv bleeding

In the 2nd / 3rd trimester

makes it a differential of antepartum haemorrhage

Question 10

How is placental praevia diagnosed?

• what measurement determines a low lying placenta?

Answer 10

TVUSS

(Low lying is seen within 20mm of cervical OS)

Question 11

What part of the examination is skipped when investigating a placenta praevia?

Answer 11

Bimanual examination - can provoke serious haemorrhage

• speculum is okay

Question 12

Lifestyle advise for placenta praevia?

Answer 12

NO sex

Delivery will be a Csection

Question 13

How can placental praevia change throughout pregnancy?

Answer 13

a low lying placeta at 20 week scan has an incidence of 5%, this changes to 0.5% as 90% move away from OS by delivery

need to rescan at 32 and 36 weeks if still low lying to determine c section

Question 14

How to manage symptomatic placenta praevia with bleeding?

Answer 14

• Admit until bleeding tops and 48 hours +
• ABCDE approach with 2 IV access and fluids

Bloods, CTG