Placenta Previae

1651 words, 7 pages

Intro Sample...


Of all placenta previas, the frequency of complete placenta previa ranges from 20-45%, partial placenta previa accounts for approximately 30%, and marginal placenta previa accounts for the remaining 25-50%.
Mortality/Morbidity
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Table
Morbidities Relative Risk
Antepartum bleeding 10
Need for hysterectomy 33
Blood transfusion 10
Septicemia 5.5
Thrombophlebitis 5
Morbidities Relative Risk
Antepartum bleeding 10
Need for hysterectomy 33
Blood transfusion 10
Septicemia 5.5
Thrombophlebitis 5

The perinatal mortality rate associated with placenta previa ranges from 2-3%.

Maternal mortality is 0.03% in the United States.

Race
Placenta previa has no predilection for any race.
Sex
Placenta previa only occurs in pregnant women.
Age
Age is associated with a varying prevalence of placenta previa. The risk of placenta previa in relation to age is as follows:
• Aged 12-19 years - 1%
• Aged 20-29 years - 0.33%
• Aged 30-39 years - 1%
• Older than 40 years - 2%
Clinical
History
The classic presentation of placenta previa is painless vaginal bleeding.
• Nearly two thirds of symptomatic patients present before 36 weeks' gestation, with half of these patients presenting before 30 weeks' gestation.
• This hemorrhage often stops spontaneously and then recurs with labor.
Physical
• Any pregnant patient beyond the first trimester who presents with vaginal bleeding requires a speculum examination followed by diagnostic ultrasound, unless previous documentation confirms no placenta previa.
• Because of the risk of provoking life-threatening hemorrhage, a digital examination is absolutely contraindicated until placenta previa is excluded.
• Uterine activity monitoring reveals that approximately 20% of patients have concurrent contractions with their bleeding.
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