Is also referred to as Placenta praevia

Is when a change of placement of the placenta is found during pregnancy

Under normal conditions the placenta is attached to the uterine wall

With placenta previa the placenta shifts downward and approaches the cervix and often covers it.

It is typically seen during the third trimester but can actually occur during the first or second.

Is a major reason for vaginal bleeding during pregnancy.

Occurs in almost 0.5% of all pregnancies.

Symptoms:

   -    Vaginal bleeding – often bright red
   -    Often there is no pain involved
   -    Abdomen is often soft

Classifications:

1.)   Type I  –  low lying  -  Approaches the lower uterus, not affecting the cervical os
2.)   Type II  –  marginal  –  Touch the top of cervix
3.)   Type III  -  partial  –  Partially covers top of cervix
4.)   Type IV  -  complete  -  Entire top of cervix is covered

Risk Factors

   -    A previous placenta previa
   -    A previous abortion
   -    A previous C-section delivery
   -    Large placenta
   -    Smoking
   -    Age – below 20 and above 30

Ultrasound is very important in diagnosis

Treatment:

   -    Initially treatment was provided solely inside hospitals once the diagnosis was made
   -    Today, more treatment is allowed on an outpatient basis as long as mother and child are not in any distress.
   -    Also – fetus is less than 30 weeks

   -    If distress is present- immediate delivery may be the only option

   -    Vaginal delivary is an option in some cases but many are delivered by C-section

   -    The concerning factor for vaginal delivery is continued separation of the placenta and the uterus – this will increase bleeding and it becomes more dangerous for the mother.