During the early part of pregnancy, the placenta is typically attached at the lower portion of the uterus (low-lying), however as pregnancy progresses and the uterus grows, the placenta usually migrates upward.
In Placenta Previa (PP), the placenta remains attached in the lower portion of the uterus and either touches or obscures (partially or completely) the internal cervical os through which the baby must pass to be born. Sometimes this is due to a condition called placenta accreta, which is the abnormally firm attachment of the placenta to the uterine wall.
PP affects 1 in 200 births. The risk increases to 1-4 % after one previous cesarean delivery and up to 10% after four or more cesarean deliveries.
The focus of care for the initial episode of bleeding is the assessment and stabilization of the situation and the determination of the safety of outpatient versus in-hospital monitoring. If the fetus is preterm (< 37 weeks) and there is no need for immediate delivery (no hemorrhage), then outpatient monitoring will probably be deemed appropriate. Three quarters of women with PP will be delivered by cesarean section.
The Medifocus Guide on Placenta Previa provides answers to the following important questions and medical issues:
What are the most common symptoms of placenta previa?
Are there any recognized risk factors for developing placenta previa?
What kinds of medical tests are used to establish the diagnosis of placenta previa?
What is the current standard of care for the treatment of placenta previa?
What treatment options are available for the management of placenta previa?
Are there any promising new developments or potential breakthroughs in treatment?
Who are the most notable medical authorities who specialize in placenta previa?
Where are the leading hospitals and centers of research for placenta previa?
What are the most important questions to ask my doctor about placenta previa?
What Your Doctor Reads:
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Interventions for suspected placenta praevia. Cochrane Database of Systematic Reviews [computer file]. 2000
Obstetric history and the risk of placenta previa. Acta Obstetricia et Gynecologica Scandinavica. 2000
Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound in Obstetrics & Gynecology. 2000
Maternal serum second trimester AFP and hCG in pregnancies with placenta previa. Prenatal Diagnosis. 2000
Emergency postpartum hysterectomy in women with placenta previa and prior cesarean section. International Journal of Gynaecology & Obstetrics. 2000
Previous cesarean section and abortion as risk factors for developing placenta previa. Journal of Obstetrics & Gynaecology Research. 1999
Placenta previa: a 22-year analysis. American Journal of Obstetrics & Gynecology. 1999
Placenta previa: preponderance of male sex at birth. American Journal of Epidemiology. 1999
Neonatal outcomes with placenta previa. Obstetrics & Gynecology. 1999
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