Difference between revisions of "Placenta previa"

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==Background==
 
==Background==
# placenta improperly positioned between cervic and baby. can be total, partial or marginal
+
#Placenta that extends near, partially over, or beyond the internal cervical os
# tx c c section
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##Can be total, partial, or marginal
# hem from early separation of placenta from ut- due to gradual thinning of cervix in anticipation of delivery.  can also be by physical exertion, labor, local trauma (intercourse, speculum exam)
+
#Do NOT perform digital or speculum exam
# assoc with intrauterine growth retardation, congenital abnormalities, and placenta prev.
 
  
 
==Risk Factors==
 
==Risk Factors==
# c section
+
#Uterine sx
# previous pl previa
+
#Advanced maternal age
# twins
+
#Cigarette smoking
# D&C
+
#Cocaine abuse
# muliparous
 
# scarring of uterus with no place for placenta to attach except at botton near cervix
 
  
 
==Diagnosis==
 
==Diagnosis==
# painless bright red blood
+
*Painless vaginal bleeding
# exam only with double set up in OR by obstetrician
+
*US
# in ER use abd utz
+
**Shows position of placenta
# 90% of prev dx before 20 wks will have placnta that migrates away from cervix or lower ut  segmnt will grow more
+
 
 +
==Management==
 +
#Type + cross
 +
#CBC
 +
#Coags
  
 
==Treatment==
 
==Treatment==
# c section
+
#C-section
# if fetus not viable, tx in hospital until viable then c section
+
 
 +
==Source==
 +
Tintinalli
  
 
[[Category:OB/GYN]]
 
[[Category:OB/GYN]]

Revision as of 01:19, 25 August 2011

Background

  1. Placenta that extends near, partially over, or beyond the internal cervical os
    1. Can be total, partial, or marginal
  2. Do NOT perform digital or speculum exam

Risk Factors

  1. Uterine sx
  2. Advanced maternal age
  3. Cigarette smoking
  4. Cocaine abuse

Diagnosis

  • Painless vaginal bleeding
  • US
    • Shows position of placenta

Management

  1. Type + cross
  2. CBC
  3. Coags

Treatment

  1. C-section

Source

Tintinalli