Placenta Praevia

Question 1

What is Placenta Praevia?

Answer 1

When a baby’s placenta partially or totally covers the cervix of the mother.

This can cause severe bleeding during pregnancy and delivery.

Question 2

How common is placenta praevia?

Answer 2

1 in 200 pregnancies.

Question 3

Which women are more susceptible to placenta praevia? (2)

Answer 3

• Multiparity

- History of previous caesarean section.

Question 4

What are the classifications of placenta praevia? (4)

Answer 4

Grade I - Placenta enroaching on the lower segment, but not the internal cervical os.

Grade II - Placenta reaches the internal os.

Grade III - Placenta eccentrically covers the os.

Grade IV - Central placenta praevia.

Question 5

What is the main presentation of placenta praevia?

Answer 5

PAINLESS bright red vaginal bleeding,

during the SECOND HALF of pregnancy.

Question 6

What are the presentations of placenta praevia? (3)

Answer 6

• No Pain but bleeding from vagina
• Malpresentation of the fetus
• Soft uterus and Non tender uterus

Question 7

What investigation do we conduct for suspected placenta praevia?

Answer 7

Ultrasound scan, to locate placental site.

Question 8

What investigation MUST NOT EVER be conducted with suspected placenta praevia?

Answer 8

Vaginal Exam.

May rupture the placenta!

Question 9

How do we manage placenta praevia? (2)

Answer 9

• Allowing normal gestation.

- Caesarean section (for major placenta praevia)