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Placenta previa
From WikEM
Contents
Background
- Placenta that extends near, partially over, or beyond the internal cervical os
- Can be total, partial, or marginal
- Do NOT perform digital or speculum exam
Risk Factors
- Uterine scar
- Advanced maternal age
- Cigarette smoking
- Cocaineabuse
Evaluation
- Painless vaginal bleeding
- U/S - obtain position of placenta
Differential Diagnosis
Abdominal Pain in Pregnancy
<20 Weeks
- Ectopic pregnancy
- First trimester abortion
- Complete Abortion
- Threatened Abortion
- Inevitable Abortion
- Incomplete Abortion
- Missed Abortion
- Septic abortion
- Ovarian torsion
- Incarcerated uterus
- Malposition of the uterus
- Non-pregnancy related causes
>20 Weeks
- Labor/Preterm labor
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Vaginal trauma
- HELLP syndrome
- Chorioamnionitis
- Incarcerated uterus
- Malposition of the uterus
- Non-pregnancy related causes
- Placenta accreta
- Placenta increta
- Placenta percreta
Management
- Type + cross
- Rho status
- CBC
- Coags
- Fetal Heart Monitoring
- Consult OBGYN and NICU/Neonatal/Peds Immediately
Management
- Fluids Resus/Blood Products
- C-section
- Neonatal/Maternal Resus as needed
References
