Placenta Previa

Mabie, William C.

doi:10.1016/s0095-5108(18)30465-2

Cited by 35 publications

(20 citation statements)

References 30 publications

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“…The observed incidence of placenta praevia of 0.4% in our study is in keeping with current literature 1,2 , and our data objectively confirm the perception that the clinical course of women with a placenta praevia is unpredictable. The degree of praevia was not predictive of the likelihood of bleeding which, while contrary to common opinion 6 , supports previous findings 10 . There were no features specific to those women who were delivered within 12 h of bleeding onset that would have predicted their need for emergency delivery.…”

Section: Discussionsupporting

confidence: 78%

Pregnancies complicated by placenta praevia: what is appropriate management?

Love¹,

Wallace

1996

BJOG

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Objective To review the outcome of pregnancies complicated by placenta praevia over a three‐year period (1991–1993) and to describe in detail the antenatal course and the events leading to delivery, assessing retrospectively whether there are clinical features predictive of outcome and whether outpatient management would be reasonable. Design A retrospective review of the case records of women with a pregnancy complicated by placenta praevia. Setting A tertiary referral teaching hospital in Edinburgh. Results There were 15,930 deliveries in the study period. Fifty‐eight women (0.4%) had a placenta praevia in the third trimester, 42 of whom (72%) had at least one episode of bleeding. Overall, 62% of the women had a major praevia with no differences in the grade of praevia between those women who did or did not have bleeding. Both diagnosis and delivery occurred significantly earlier in women with antepartum bleeding than in those without (median gestation at diagnosis 28.6 weeks versus 33.3 weeks (P < 0.01) and at delivery 36.0 weeks versus 37.1 weeks (P= 0.04), respectively). Delivery by emergency caesarean section was more common in women with bleeding (62%versus 38%). An increasing number of bleeding episodes experienced by individuals was not associated with significant differences in outcomes. Rapid emergency delivery for bleeding was necessary for three women, in none of whom could the bleeding have been predicted. Conclusions The clinical outcomes of placenta praevia are highly variable and cannot be predicted confidently from antenatal events. Nonetheless, in the majority of cases with or without bleeding and irrespective of the degree of praevia, outpatient management would appear safe and appropriate.

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Section: Discussionsupporting

confidence: 78%

Pregnancies complicated by placenta praevia: what is appropriate management?

Love¹,

Wallace

1996

BJOG

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“…This placental migration is due to the fact that the lower segment grows faster than the placenta, and the net result of this differential growth rate is that the lower placental edge appears to move away from the internal cervical os. 1,14,17,18 While some studies have claimed that the type and degree of placenta previa may indicate the type of delivery and clinical outcome, 13,15,1 other studies have shown that the degree of placenta previa is not predictive of clinical outcomes. 4,14,20 Our study shows that the implantation site (whether anterior or posterior), the distance of the lower placental margin from the internal cervical os, and the relationship between the presenting part and the placental margin are important sonographic findings.…”

Section: Discussionmentioning

confidence: 99%

Placental Migration and Mode of Delivery in Placenta Previa: Transvaginal Sonographic Assessment During the Third Trimester

Ghourab

Al-Jabari

2000

Ann Saudi Med

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Background:The objective of this study was to assess the role of serial transvaginal sonography (TVS) in predicting placental migration and mode of delivery in pregnancy complicated by placenta previa during the third trimester. Patients and Methods: In this prospective observational study, all the cases had confirmed diagnosis of placenta previa before 32 weeks' gestation. TVS was performed between 28 and 32 weeks' gestation for 287 patients with either clinical suspicion or previous sonographic diagnosis of placenta previa. The lower placental edge was found to cover the internal cervical os, or was found to be within 3 cm from it in 63 patients. A two-weekly TVS was performed for every patient until delivery, or until migration of the lower placental edge to a distance of more than 3 cm from the internal cervical os was observed. Detailed information on the placental postion, its distance from the internal cervical os, and its relation to the presenting part were recorded at each examination. Results: Placental migration to a distance of more than 3 cm from the internal cervical os occurred in 24 patients (38%) by 36 weeks' gestation. Of the 63 patients, 19 (30.2%) delivered vaginally. The last scan of these patients revealed that the distance between the internal cervical os and the lower placental margin were more than 2 cm and 3 cm in the anterior and posterior placenta previa, respectively, and the presenting parts were below the placental margin. Placental migration was not observed sonographically in any of the eight patients with posterior placenta previa when its lower edge was initially located within 1 cm from the internal os. It was also not observed in either the 16 patients with total placenta previa, or in any of the other patients beyond 36 weeks' gestation. Conclusion: Posterior placenta previa lying within 1 cm from the internal cervical os and total placenta previa do not migrate during the third trimester. On the other hand, other types of placenta previa may migrate but not beyond 36 weeks' gestation. The mode of delivery does not depend only on the placental degree but also on the placental position (anterior or posterior), and the relationship between the presenting part and the lower placental edge.

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“…Cette crainte est d'autant plus justifiée que le diagnostic de placenta praevia recouvrant est souvent mé-connu jusque tard au cours de la grossesse. C'est l'introduction du doigt dans le canal cervical qui va faire prendre un risque de saignement [34]. Le TV peut être avantageusement remplacé par l'échographie tant en terme d'information apportée qu'en terme d'innocuité.…”

Section: Un Risque De Saignement En Cas De Tv Sur Placenta Praeviaunclassified

Contre le toucher vaginal systématique en obstétrique

Vayssière¹

2005

Gynécologie Obstétrique & Fertilité

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Placenta Previa

Cited by 35 publications

References 30 publications

Pregnancies complicated by placenta praevia: what is appropriate management?

Pregnancies complicated by placenta praevia: what is appropriate management?

Placental Migration and Mode of Delivery in Placenta Previa: Transvaginal Sonographic Assessment During the Third Trimester

Contre le toucher vaginal systématique en obstétrique

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