Placenta previa

Revision as of 10:02, 22 March 2015 by Arsmd (talk | contribs) (Treatment)

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

  • Uterine scar
  • Advanced maternal age
  • Cigarette smoking
  • Cocaine abuse

Diagnosis

  • Painless vaginal bleeding
  • U/S - obtain position of placenta

Differential Diagnosis

Abdominal Pain in Pregnancy

The same abdominal pathologies as non-pregnant patients, plus:

<20 Weeks

>20 Weeks

Any time

  • Hemorrhagic ovarian cyst
  • Fibroid degeneration or torsion
  • Ovarian torsion
  • Constipation

Management

  • Type + cross
  • Rho status
  • CBC
  • Coags
  • Fetal Heart Monitoring
  • Consult OBGYN and NICU/Neonatal/Peds Immediately

Treatment

  • Fluids Resus/Blood Products
  • C-section
  • Neonatal/Maternal Resus as needed

Source

Tintinalli

See Also

Vaginal Bleeding (Main)