What is a low-lying placenta?

Oppenheimer, Lawrence; Farine, Dan; Ritchie, J. W. K.; Lewinsky, Reuven M.; Telford, Joyce; Fairbanks, Lynn A.

doi:10.1016/0002-9378(91)90465-4

Cited by 105 publications

(89 citation statements)

References 6 publications

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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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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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“…5 In our study, first trimester bleeding was found in 54% cases and second trimester bleeding was found in 73% cases these patients were monitored closely as inpatients and more aggressively managed. 6 In our study, 72% cases of placenta previa was delivered by caesarean section. Though our protocol is elective CS at 37 weeks, more than 50% of cases were emergency LSCS due to recurrent bleeding.…”

Section: Discussionmentioning

confidence: 48%

“…6 It is reasonable to hospitalize women with placenta previa while they are having an acute bleeding episode or uterine contractions. The blood bank must be capable of making available at least 4 units of compatible packed red blood cells and coagulation factors at short notice.…”

Section: Management Of Patients With Bleedingmentioning

confidence: 99%

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Maternal and fetal outcome of Placenta Previa at a tertiary centre in North Kerala, India

Sidhiq

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.Methods: This study was conducted in the Department of Obstetrics and Gynaecology during the period from June 2016 to May 2017 including antenatal patients of 24 weeks of gestation regardless of their parity. They would be selected from the same O.P day as that of case in a 1:4 case: control manner. Statistical analysis was done using SPSS version 16.0 for Windows.Results: Age, booking status, Gestational age at delivery and gravidity was comparable between the two groups. The risk for placenta praevia was more among patients with a previous history of CS. Risk for antepartum bleeding was significantly higher among cases of placenta praevia. CS rate and proportion of patients who required blood transfusion was significantly high among cases. Intraoperative and postoperative complications were significantly higher among cases. There was no significant difference in neonatal death rate and NICU admission rate between the two groups.Conclusions: Incidence of placenta previa is 0.78%. There is significant association with placenta previa and maternal morbidity, first trimester and second trimester bleeding increased blood transfusions, need for caesarean section, prolonged hospital stay, previous caesarean section, previous dilatation and curettage, placenta accreta, postoperative complications and NICU admission. Measures to reduce the primary caesarean section rate should be adopted.

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“…This has rendered traditional classification of placenta previa obsolete. 8,9,10,11 False positives may be due to following reasons. 12 Overfilled bladder compressing lower uterine segment.…”

Section: Introductionmentioning

confidence: 99%