Placenta praevia Flashcards
what is it
placenta lies in lower uterine segment
what are the risks of it
significant haemorrhage by mother and fetus
what should be avoided w PP
digital PV examinations
no penetrative sex
What is the difference between minor and major pP
major = placenta covering internal os minor = placenta in lower segment but not covering internal os
What is PP associated w
- Multiparity
- Multiple pregnancy
- CS
- > 40yrs
- D&C
- Fibroids
What are clinical features of PP
→ APH - separation of the placenta as lower segment stretches causes bleeding → Shock in proportion to visible loss → No pain → Non-tender uterus → Abnormal lie and presentation → Fetal heart usually normal
What can help diagnose pp
TVS - localises placenta
Usually picked up on routine 20 week abdo US
How is placenta praaevia managed if major
CS
What is the mode of delivery w minor PP
normal unless gets w/in 2cm of internal os
What is vasa praevia
fetal vessels risk damage at membrane rupture causing fatal haemorrhae
What is presentation of vasa praevia
ROM followed immediately by vaginal bleeding
fetal bradycardia
what is management of vasa praevia
CS
what is risk of velamentous insertion
vessels are exposed and prone to rupturing
What is placenta succenturia
separate lobe of placenta away from main one
what is risk of placenta succenturia
may fail to separate normally and cause a PPH or puerperal sepsis
