Placenta Previa

A short presentation in Embrology about placenta previa, its types, symptoms, and how it is diagnosed.

1. CASE STUDY

2. A 40 year old pregnant female of 30 weeks gestation presents to the emergency room because of vaginal bleeding of 1 month duration. Spotty during the early days but significant over the last 5 days. The patient also reports some contractions but denies any continuing abdominal pain. She denies any recent trauma. Her first baby was delivered via caesarean section. She also revealed that she had been smoking for the last 15 years. On physical examination, her blood pressure was 80/60, heart rate was 105/min. The uterus was soft and tender. There was normal fetal heart tones.

3. Based on the history and physical examination, what is the most likely diagnosis? Explain why this is your diagnosis.

4. What is Placenta Previa? Placenta previa is a complication of pregnancy in which the placenta is implanted either near to or overlying the outlet of the uterus. Placenta previa is found in approximately four out of every 1000 pregnancies beyond the 20th week of gestation. The main symptom of placenta previa is bleeding.

5. Types of Placenta Previa Partial Marginal Low-lying Complete

6. Symptoms of Placenta Previa Bleeding is the primary symptom of placenta previa and occurs in the majority (70%-80%) of women with this condition. Vaginal bleeding after the 20th week of gestation is characteristic of placenta previa. Usually the bleeding is painless, but it can be associated with uterine contractions and abdominal pain. Bleeding may range in severity from light to severe.

7. What are the diagnostic exams that should be done to confirm this diagnosis? Placenta previa is diagnosed through ultrasound, either during a routine prenatal appointment or after an episode of vaginal bleeding. Most cases of placenta previa are diagnosed during a second trimester ultrasound exam. Diagnosis might require a combination of abdominal ultrasound and transvaginal ultrasound. If the doctor suspects placenta previa, they will avoid routine vaginal exams to reduce the risk of heavy bleeding.