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Placenta praevia
Patient (condition)
 
Aliases:
Placenta previa

Topic aliases are alternate phrasings for a particular topic.


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Abnormal placentation in which the PLACENTA implants in the lower segment of the UTERUS (the zone of dilation) and may cover part or all of the opening of the CERVIX. It is often associated with serious antepartum bleeding and PREMATURE LABOR.
www.nlm.nih.gov/cgi/mesh/...

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Assess grade on ultrasound:
Grade I - Lower segment;
Grade II - Touches cervix;
Grade III - Partially covers cervix;
Grade IV - covers cervix.
refl.in/2c

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Patients with placenta praevia, and a history of previous caesarean section, are at increased risk of placenta accreta, increta & percreta

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At risk of antenatal haemorrhage. Will be booked in for early elective caesar at 36-38/40

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Two large bore intravenous cannulae (16-14g)

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May 18, 2011
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If choosing neuraxial technique in a patient with borderline increased risk of haemorrhage (a GA would be safest in high risk patients), ensure they are a low risk intubation. You don't want to deal with a difficult airway when converting to GA. #safety

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Dec 06, 2012
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If the decision has been made to proceed with a neuraxial block in a patient with a borderline increased risk of haemorrhage, consider converting to a GA early on if excessive bleeding is noted before hypotension and vomiting begin to complicate the management of the patient's airway.

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Patients with a low anterior placenta, especially in cases of previous section or active bleeding, should generally have a general anaesthetic so that the anaesthetist isn't required to manage both haemorrhage and the patient's airway simultaneously. refl.in/praevia

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At increased risk of post partum haemorrhage as the lower uterine segment does not contract as well.

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At risk of surgical haemorrhage during caesarian section if the placenta is lying low in the anterior segment.

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Dec 20, 2011
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Amount of cross matched blood required will depend on the clinical features of each individual case & the local blood bank services.

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