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PLACENTA PREVIA - PowerPoint PPT Presentation


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PLACENTA PREVIA. Lin Qi De. Definition. Placenta previa: Abnormal location of the placenta over ,or in close proximity to the internal os. Incidence: approximately 1 /250 pregnancy nulliparas: 1/1000~1/1500 pregnancy grandmultiparas: 1/20. Classification.

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Presentation Transcript
slide2

Definition

Placenta previa: Abnormal location of the placenta over ,or in close proximity to the internal os.

Incidence:approximately 1 /250 pregnancy

nulliparas: 1/1000~1/1500 pregnancy

grandmultiparas: 1/20

slide3

Classification

Complete (total) placenta previa:entire cervical os is covered

Partial placenta previa:the margin of the placenta extends across but not all of the internal os.

Marginal:edge of the placenta lies adjacent to the internal os

Low lying placenta:placenta is located near but not directly adjacent to the internal os.

slide4

Etiology

  • Mechanism:abnormal vascularization
  • Predisposing factors:
  • Twin pregnancy
  • Increasing maternal age
  • Increasing parity
  • Previous cesarean section
slide5

diagnosis

Painless vaginal bleed:

first bleeding episode is 29~30 weeks

Ultrasonography:

benefit in localizing the placenta and diagnosis placenta previa

slide6

Caution

Double setup vaginal examination

No digital vaginal or rectal examination is preformed in case of placenta previa . Only as a final and definitive event and only under conditions of double set up.

This procedure involves careful evaluation of the cervix in the operation room with full preparations for rapid cesarean section.

slide7

Management

  • Basic management
  • Initial hospitalization with hemodynamic stabilization
  • Enforced bed rest
  • Restrictions of activity
slide8

Expectant management

  • (allow for further fetal growth and maturation)
  • Blood transfusion is given as necessary
  • Amniocentesis for fetal lung maturity testing
  • Cesarean birth if fetus is thought to be mature
slide9

Indication of vaginal delivery

  • Delivery can be accomplished with minimal blood loss
  • Fetus is dead
  • Major fetal malformation
slide10

Complication

  • Placenta previa accreta
  • Postpartum hemopphage
  • Increasing maternal mortality and perinatal mortality