Placenta previa: Difference between revisions
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==Background== | ==Background== | ||
[[File:2910 The Placenta-02.jpg|thumb|Normal placental anatomy.]] | |||
[[File:Placta prv.jpg|thumb|Schematic of placenta previa.]] | |||
[[File:Placenta previa.png|thumb|Placenta previa subtypes.]] | |||
*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== | ||
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*Advanced maternal age | *Advanced maternal age | ||
*Cigarette smoking | *Cigarette smoking | ||
*Cocaine abuse | *[[Cocaine]] abuse | ||
==Clinical Features== | |||
*Painless [[Vaginal bleeding in pregnancy (greater than 20wks)|vaginal bleeding]] in 3rd trimester | |||
**May be profuse, bright red | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Abdominal Pain Pregnancy DDX}} | {{Abdominal Pain Pregnancy DDX}} | ||
== | ==Evaluation== | ||
*[[Pelvic ultrasound]] - obtain position of placenta | |||
*Type + cross | *Type + cross | ||
*Rho status | *Rho status | ||
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*Coags | *Coags | ||
*Fetal Heart Monitoring | *Fetal Heart Monitoring | ||
== | ==Evaluation== | ||
* | ==Management== | ||
* | *Requires cesarean- consult ob/gyn emergently | ||
* | *Resuscitate | ||
==Dispo== | |||
*Admit | |||
==See Also== | |||
*[[Vaginal Bleeding (Main)]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:OBGYN]] | [[Category:OBGYN]] | ||
Latest revision as of 23:11, 11 December 2024
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