Placenta Praevia Flashcards
What is the RCOG definition of a Low lying placenta?
Placenta within 20mm of Internal cervical os (but not covering it)
What is the RCOG definition of Placenta Praevia?
Placenta covering Internal cervical os
What is the percentage of the incidence of Placenta Praevia?
1% of pregnancies
What is Placenta Praevia a notable cause of?
Antepartum haemorrhage
What are the 3 main causes of Antepartum haemorrhage?
- Placenta praevia
- Placental abruption
- Vasa praevia
What are the RF for Placenta praevia? (6 things)
- Previous C sections (main RF)
- Hx of Placenta praevia
- Age 40+
- Smoking
- Structural uterine abn (e.g fibroids)
- IVF
What is the main CF of Placenta praevia? (2 things)
- Asymptomatic (most)
- Painless vaginal bleeding
When does bleeding usually occur in Placenta praevia?
Late, aka 36+ weeks
What are some DDx that present similarly to Placenta Praevia? (5 things)
- Placental abruption
- Vasa praevia
- Uterine rupture
- Benign / malignant lesions (e.g polyps / carcinoma)
- Infection (e.g candida / bac vaginosis / chlamydia)
What should you do if sus MAJOR bleeding and you haven’t done any investigations?
Resus + do investigations at same time
What investigations should you do for bleeding at Placenta praevia? (8 things)
- FBC (anaemia)
- UnE
- LFT
- Clotting profile
- G&S
- Crossmatch
- Kleihauer test (if woman Rh negative)
- CTG
What do you do the Kleihauer test for? (2 steps)
- To determine amount of Feto-maternal haemorrhage
- Thus dose of Anti-D req
What is the point of CTG in Placenta praevia investigation?
To assess foetal wellbeing
What investigation gives you the definitive Dx of Placenta praevia?
US
What does RCOG recommend for woman Dx w Placenta praevia at 20 wk anomaly scan? (2 things)
Repeat US @:
1. 32 weeks
1. 36 weeks (if still present @ 32 wks)
