Placenta praevia

Question 1

what is it?

Answer 1

Placenta praevia describes a placenta lying wholly or partly in the lower uterine segment

PAINLESS

Question 2

associated factors

Answer 2

multiparity
multiple pregnancy
embryos are more likely to implant on a lower segment scar from previous caesarean section

Question 3

features

Answer 3

shock in proportion to visible loss
no pain
uterus not tender
lie and presentation may be abnormal
fetal heart usually normal
coagulation problems rare
small bleeds before large

Question 4

DDX

Answer 4

routine abdominal US 20 weeks

TVUS

Question 5

classical grading

Answer 5

I - placenta reaches lower segment but not the internal os

II - placenta reaches internal os but doesn’t cover it

III - placenta covers the internal os before dilation but not when dilated

IV (‘major’) - placenta completely covers the internal os