Antenatal Care - Placenta Praevia

Question 1

What is Placenta Praevia?

Answer 1

The placenta is attached in the lower portion of the uterus, lower than the presenting part of the foetus.

Question 2

Difference between Low-Lying Placenta and Placenta Praevia.

Answer 2

LLP : Placenta is within 20mm of the Internal Cervical Os.
PP : Placenta is over the Internal Cervical Os.

Question 3

Differential Diagnoses of Antepartum Haemorrhage (3).

Answer 3

1. Placenta Praevia.
2. Placental Abruption.
3. Vasa Praevia.

Question 4

Differential Diagnoses of Spotting/Minor Bleeding in Pregnancy (3).

Answer 4

1. Cervical Ectropion.
2. Infection.
3. Vaginal Abrasions (Intercourse/Procedures).

Question 5

Risk Factors of Placenta Praevia (6).

Answer 5

1. Previous C-Sections.
2. Previous Placenta Praevia.
3. Older Maternal Age.
4. Maternal Smoking.
5. Structural Uterine Abnormalities.
6. Assisted Reproduction e.g. IVF.

Question 6

Diagnosis of Placenta Praevia.

Answer 6

1. 20 Week Anomaly Scan : Position of Placenta.
2. APH - 36+ Weeks.

Question 7

Management of Diagnosed Placenta Praevia.

Answer 7

1. Repeat TVUS at 32 Weeks, 36 Weeks - to guide decisions about delivery.
2. Anticipatory Antenatal steroids between 34-36 Weeks.
3. Planned C-Section between 36-37 Weeks.