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Placenta Previa
(GY013)

Introduction


During the early part of pregnancy, the placenta is typically attached at the lower portion of the uterus (low-lying), however as pregnancy progresses and the uterus grows, the placenta usually migrates upward.

In Placenta Previa (PP), the placenta remains attached in the lower portion of the uterus and either touches or obscures (partially or completely) the internal cervical os through which the baby must pass to be born. Sometimes this is due to a condition called placenta accreta, which is the abnormally firm attachment of the placenta to the uterine wall.

PP affects 1 in 200 births. The risk increases to 1-4 % after one previous cesarean delivery and up to 10% after four or more cesarean deliveries.

The focus of care for the initial episode of bleeding is the assessment and stabilization of the situation and the determination of the safety of outpatient versus in-hospital monitoring. If the fetus is preterm (< 37 weeks) and there is no need for immediate delivery (no hemorrhage), then outpatient monitoring will probably be deemed appropriate. Three quarters of women with PP will be delivered by cesarean section.

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