Placenta previa: Difference between revisions
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==Background== | ==Background== | ||
[[File:2910 The Placenta-02.jpg|thumb|Normal placental anatomy.]] | |||
*Placenta that extends near, partially over, or beyond the internal cervical os | |||
**Can be total, partial, or marginal | |||
*Do NOT perform digital or speculum exam | |||
==Risk Factors== | ==Risk Factors== | ||
Revision as of 19:25, 14 December 2022
Background
- Placenta that extends near, partially over, or beyond the internal cervical os
- Can be total, partial, or marginal
- Do NOT perform digital or speculum exam
Risk Factors
- Uterine scar
- Advanced maternal age
- Cigarette smoking
- Cocaine abuse
Clinical Features
- Painless vaginal bleeding in 3rd trimester
- May be profuse, bright red
Differential Diagnosis
Abdominal Pain in Pregnancy
The same abdominal pain differential as non-pregnant patients, plus:
<20 Weeks
- Ectopic pregnancy
- First trimester abortion
- Complete abortion
- Threatened abortion
- Inevitable abortion
- Incomplete abortion
- Missed abortion
- Septic abortion
- Round ligament stretching
- Incarcerated uterus
- Malposition of the uterus
>20 Weeks
- Labor/Preterm labor
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Vaginal trauma
- HELLP syndrome
- Cholestasis of pregnancy
- Chorioamnionitis
- Incarcerated uterus
- Acute fatty liver of pregnancy
- Malposition of the uterus
- Placenta accreta
- Placenta increta
- Placenta percreta
Any time
- Hemorrhagic ovarian cyst
- Fibroid degeneration or torsion
- Ovarian torsion
- Constipation
Evaluation
- Pelvic ultrasound - obtain position of placenta
- Type + cross
- Rho status
- CBC
- Coags
- Fetal Heart Monitoring
Evaluation
Management
- Requires cesarean- consult ob/gyn emergently
- Resuscitate
Dispo
- Admit