UW placenta previa 02-18 (1)

Question 1

UW. table placenta previa. Risk factors. 3

Answer 1

prior placenta previa
prior S/C delivery
Multiple gestation

+ multiparity
+ smoking
+ advanced age >=35

Question 2

UW. table placenta previa. CP?

Answer 2

Painless vaginal bleeding at >=20 weeks gestation
Mehlman rase kad painless in 3rd trimester

Question 3

UW. table placenta previa. Dx?

Answer 3

Transabdominal followed by TVUG

Question 4

UW. table placenta previa. Mx? 3

Answer 4

No intercourse
No digital cervical intervention
Inpatient admission for bleeding episodes

Question 5

UW. placenta previa. definition?

Answer 5

placenta covers the cervix.

Question 6

UW. placenta previa. has the potential for massive antepartum hemorrhage because cervical manipulation …….

Answer 6

(even minimal manipulation from intercourse) causes partial placental detachment and painless vaginal bleeding (eg, nontender uterus, painless irregular contractions) from the intervillous space.

Question 7

UW. placenta previa. origin of bleeding?

Answer 7

primarily of maternal origin; therefore, many patients have reassuring fetal monitoring initially (eg, accelerations, no decelerations).

Question 8

UW. placenta previa. Tx depends on what?

Answer 8

maternal hemodynamic stability and fetal status.

Question 9

UW. placenta previa. Mx. Stable patients are managed …?

Answer 9

expectantly, as most previas resolve by the third trimester.

Question 10

UW. placenta previa. Mx. patients with persistent previa undergo ……

Answer 10

cesarean delivery at 36-37 weeks gestation (prior to the onset of labor).

Question 11

UW. placenta previa. whats about contractions?

Answer 11

Painless bleeding with or without contractions

Question 12

UW. placenta previa: can cause massive maternal bleeding –> Therefore, even in patients with minimal bleeding, stable vital signs, and reassuring fetal heart rate tracings, cesarean delivery is indicated after 36-37 weeks gestation

Answer 12

.

Question 13

UW. Dx on routine ultrasound, but if patient didnt have prenatal care or eg immigrated, it might be missed and observed only before/at labor

Answer 13

.

Question 14

UW. eg need emergency S/c at 37 w. Whats about Anti-D immunoglobulin?

Answer 14

Because anti-D immunoglobulin is protective when given up to 72 hours after delivery, it can be administered postpartum if indicated.

Question 15

UW. what examination is forbiden in placenta previa?

Answer 15

Digital cervical examination

Question 16

UW. what examination is allowed in placenta previa?

Answer 16

speculum examination, as it does not enter the cervical canal.

eg used to verify and quantify vaginal bleeding evaluate bleeding