Placenta Previa

Question 1

What is classification of placenta previa?

Answer 1

Grade1or minor placenta:
Lower edge of placenta reach the lower uterine segment.
Grade 2 marginal:
The lower edge reach the internal os.
Grade 3 partial placenta previa.
Edge cover cervix partially.
Grade 4:
Edge cove the cervix completely.
1&2 minor
3&4 major

Question 2

Classify placenta accreta?

Answer 2

1- Creta: adherents superficial to the myometrium, not invading the decidua.
2- increta: villi penetrate deeply the myometrium down to the serosa.
3- percreta:
Villus penetrate through the entire wall of uterus and invade surrounding pelvic organs.

Question 3

Management of placenta previa?

Answer 3

Placenta previa 6 bundle care
Reflect good care
1-Consultant obstetrician planning and supervising delivery
2-Consultant anaesthesia planing and supervising delivery.
3- MDT involvement in pre operative planning.
4- discussion and consent including possible interventions, such as hysterectomy, leaving placenta in situ, cell salvage,
Intervention radiology
5- Level 2 care ICU and NICU
6- Logistic support and immediate access to bank products.
Team with expertise in complex pelvic surgery.

Question 4

What important things to remember in placenta previa?

Answer 4

Cervix measurement before 34 weeks. Short cervix less than 30 mm caus Preterm emergency delivery.

Question 5

What type of scan

Answer 5

Colour flow Doppler

Question 6

Time of delivery?

Answer 6

Asymptomatic: section 36-37, steroid between 34-35+6
Symptomatic:
Section 34-36, steroid before 34 w

Question 7

Risk of accreta with previa?

Answer 7

0 section = 3-4%
1 section= 10-15%
2section = 25-40%
3 section = 50-65%