On this page:. Bahlmann Contributor , R. Bollmann Contributor , R. Chaoui Contributor. Obstet Gynecol. Carol B. Benson Editor , Edward I. Bluth Editor. Lawrence Impey. Obstetrics and Gynecology. Trop Med Int Health. Related articles: Pathology: Genitourinary.
Promoted articles advertising. Figure 1: type I - low lying placenta Figure 1: type I - low lying placenta. It is more common in women who have had one or more of the following: More than one child A cesarean birth Surgery on the uterus Twins or triplets What Are The Different Types?
Complete Previa: the cervical opening is completely covered Partial Previa: a portion of the cervix is covered by the placenta Marginal Previa: extends just to the edge of the cervix What Are The Symptoms?
Other Signs and Symptoms Include: Premature contractions Baby is breech, or in a transverse position Uterus measures larger than it should according to gestational age What Is The Treatment?
Most physicians will also recommend limiting the following activities: Avoid intercourse Limit traveling Avoid pelvic exams What Causes Placenta Previa? The exact cause is unknown. However, the following can increase your risk: If over the age of 35 Had more than four pregnancies Have a history of uterine surgery regardless of incision type How Do I Cope With Placenta Previa?
Want to Know More? Understanding a High-Risk Pregnancy Preeclampsia Compiled using information from the following sources: 1. Can I get pregnant if…?
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Most cases of placenta previa, a pregnancy complication, are detected early and managed well — resulting in a healthy delivery. Back to Top. In This Article.
Continue Reading Below. More About the Placenta and Umbilical Cord. Data were obtained during routine care at our institution. Informed consent was obtained from each patient and protection of personal data and confidentiality were prioritized. Institutional review board approval was obtained, and the study has been performed in accordance with the ethical standards laid down in the Declaration of Helsinki and its later amendments.
Two women whose indications for preterm cesarean section were not antepartum hemorrhage were excluded, and a total of women were finally included in this study. Patients were categorized into complete or incomplete placenta previa according to the type of placenta previa, and they were assigned to anterior and posterior groups according to placental location.
Maternal characteristics, and perinatal outcomes, including admission, tocolytic use, antepartum hemorrhage, gestational age at bleeding onset, gestational age at delivery, birth weight, Apgar score, umbilical artery pH, placenta accreta incidence, anterior placental position, cervical length at delivery, and intraoperative blood loss, were compared between women with complete and incomplete placenta previa.
In addition, differences between the anterior and posterior groups were evaluated. According to our hospital protocol, asymptomatic women with placenta previa were treated as outpatients. However, if bleeding or frequent uterine contractions were observed, patients were immediately admitted to the hospital, where treatment, including bed rest, vaginal lavage, and augmentation of tocolytic agents such as ritodrine, magnesium sulfate, and progesterone, was implemented.
Scheduled elective cesarean section for placenta previa was usually performed at 37 weeks of gestation according to our institutional protocol, but was occasionally performed early in the 38th week in stable cases. Preterm cesarean section was performed only when massive, uncontrollable hemorrhage occurred. Blood loss over approximately ml and continuous hemorrhage without tendency of decrease is the indication for emergent cesarean section in our institute.
In women with placenta accreta, cesarean hysterectomy was performed concurrently. In all the subjects the diagnosis of placenta previa was confirmed by transvaginal ultrasound, performed by trained attending physicians within 1 week of cesarean section after placental migration.
Incomplete placenta previa comprised partial and marginal placenta previa 6. Partial placenta previa was defined as when the placenta partially covered, but the placental margin was situated within 2 cm of the internal os. Marginal placenta previa was defined when the placental margin was situated adjacent to the internal os, with the placenta not covering the os.
We employed this classification of complete and incomplete placenta previa because precise differential diagnosis of partial and marginal placenta previa is reported to be sometimes difficult in the absence of cervical dilatation Women with low-lying placenta were excluded because their clinical management differed.
Placental location was categorized as anterior or posterior, on the basis of the side of the uterine wall to which placenta was attached. Placenta accreta was diagnosed only when direct invasion of trophoblast cells into the myometrium was histologically confirmed after hysterectomy. For categorical variables, the chi-square test or Fisher's exact test was applied. For continuous variables, depending on their distribution, the independent t -test or nonparametric Mann-Whitney U test was used.
Of the women included in this study, 71 Thirty-one women There were no significant differences in maternal characteristics between women with complete and incomplete placenta previa, except in the prior cesarean rate, which was higher in women with complete placenta previa than in those with incomplete placenta previa [odds ratio OR 3. OR, odds ratio. CI, confidence interval. Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa Consequently, the incidence of preterm delivery was higher in women with complete placenta previa than in those with incomplete placenta previa Placenta accreta and anterior placental position were significantly more prevalent in women with complete placenta previa than in those with incomplete placenta previa, and intraoperative blood loss was increased in women with complete placenta previa.
NA, Not applicable. In complete placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups However, median gestational age at bleeding onset in the anterior group was lower than in the posterior group The incidence of preterm delivery was higher in the anterior group than in the posterior group The incidence of placenta accreta was higher in the anterior group than in the posterior group OR 9.
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