Placenta Praevia.pptx
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This document discusses placenta praevia, which is when the placenta implants partially or completely over the lower uterine segment. It notes the causes and risk factors, types, characteristics of bleeding, management including expectant treatment and definitive treatment depending on the type, and complications for both mother and baby. The presentation was given by Dr. Bijit Talukdar and covered the topic of placenta praevia in detail.
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The document discusses two conditions that can cause bleeding in late pregnancy - abruptio placenta and placenta previa. Abruptio placenta involves the separation of the placenta from the uterus prior to delivery and common risk factors include hypertension and trauma. Placenta previa occurs when the placenta implants in the lower uterine segment over the cervical os. Management of both conditions involves monitoring for maternal and fetal stability and either emergency c-section or planned c-section depending on gestational age and severity of bleeding. Complications can include disseminated intravascular coagulation for abruptio placenta or placenta accreta if placenta previa occurs over a previous c-section
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PLACENTA PRAEVIA-1.pptx
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. It can cause painful vaginal bleeding and is a risk factor for preterm birth and fetal complications. Diagnosis is made using ultrasound and careful examination. Management involves bed rest, monitoring for bleeding, and delivery via c-section if bleeding occurs late in pregnancy or labor begins. Nursing care focuses on monitoring for signs of decreased blood volume and tissue perfusion.
PLACENTA PRAEVIA-1.pptx
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. It can cause painful vaginal bleeding and is a risk factor for preterm birth and fetal complications. Diagnosis is made using ultrasound and careful examination. Management involves bed rest, monitoring for bleeding, and delivery via c-section if bleeding occurs late in pregnancy or labor begins. Nursing care focuses on monitoring for signs of decreased blood volume and tissue perfusion.
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This document discusses the management of preterm labor in cases of placenta previa and abruption placentae. It describes placenta previa as when the placenta is located over or near the internal os, and notes four degrees. For placenta previa, the expectant management using Macafee-Johnson's regime aims to continue the pregnancy for lung maturity up to 37 weeks without risking maternal health. For abruption placentae, where the placenta prematurely separates, active management through immediate delivery is usually indicated due to risks of further separation and fetal death. Lower segment c-section is often used for placenta previa, while vaginal delivery may be possible if the
antepartum hemorrhage diagnosis and management
Antepartum hemorrhage (APH) refers to bleeding from the genital tract between viability and delivery. The main causes are placenta previa, abruptio placenta, and local lesions. APH can be classified as minor (<50ml), major (50-1000ml), or massive (>1000ml). Placenta previa is when the placenta implants over or near the cervical os, and can be classified by type depending on coverage of the os. Risk factors include previous c-sections, curettage, smoking, and advancing maternal age. Management depends on gestational age and severity of bleeding, ranging from expectant care to expedited delivery, typically by c-section. Comp
antepartum hemorrhage diagnosis and management
Antepartum hemorrhage (APH) refers to bleeding from the genital tract between viability and delivery. The main causes are placenta previa, abruptio placenta, and local lesions. APH can be classified as minor (<50ml), major (50-1000ml), or massive (>1000ml). Placenta previa is when the placenta implants over or near the cervical os, and can be classified by type depending on coverage of the os. Risk factors include previous c-sections, curettage, smoking, and advancing maternal age. Management depends on gestational age and severity of bleeding, ranging from expectant care to expedited delivery, typically by c-section. Comp
4_bleeding before labour5823445293634423391.pptx
This document discusses two causes of antepartum hemorrhage (APH): placenta previa and abruption placentae. Placenta previa occurs when the placenta implants in the lower uterine segment, partially or fully covering the cervical os. Abruptio placentae is the premature separation of a normally implanted placenta. Both can lead to painless vaginal bleeding in pregnancy. Placenta previa is typically managed expectantly with bed rest or through cesarean section depending on the degree and bleeding. Abruptio placentae requires emergency measures and often immediate delivery due to associated risks of hemorrhage, shock, and fetal mortality. Complications, diagnosis, and
4_bleeding before labour5823445293634423391.pptx
This document discusses two causes of antepartum hemorrhage (APH): placenta previa and abruption placentae. Placenta previa occurs when the placenta implants in the lower uterine segment, partially or fully covering the cervical os. Abruptio placentae is the premature separation of a normally implanted placenta. Both can lead to painless vaginal bleeding in pregnancy. Placenta previa is typically managed expectantly with bed rest or through cesarean section depending on the degree and bleeding. Abruptio placentae requires emergency measures and often immediate delivery due to associated risks of hemorrhage, shock, and fetal mortality. Complications, diagnosis, and
najmi placenta previa final 4.pdf
This document discusses placenta previa and placenta accreta spectrum. It begins with definitions of placenta previa as implantation of the placenta over the internal cervical os. It describes placenta accreta spectrum from accreta where the placenta attaches to the myometrium without decidua, to increta with invasion into the myometrium, and percreta with invasion through the myometrium. Risk factors include placenta previa, cesarean sections, advanced maternal age, and previous uterine surgeries. Ultrasound is the main diagnostic tool but MRI can also be used. Management involves multidisciplinary care, conservative approaches when possible
najmi placenta previa final 4.pdf
This document discusses placenta previa and placenta accreta spectrum. It begins with definitions of placenta previa as implantation of the placenta over the internal cervical os. It describes placenta accreta spectrum from accreta where the placenta attaches to the myometrium without decidua, to increta with invasion into the myometrium, and percreta with invasion through the myometrium. Risk factors include placenta previa, cesarean sections, advanced maternal age, and previous uterine surgeries. Ultrasound is the main diagnostic tool but MRI can also be used. Management involves multidisciplinary care, conservative approaches when possible
Antepartum Hemorrhage(APH)
Under the topic of (APH) I talked about the most common causes of (APH) which are placental causes, including Placental Abruption, Placenta Previa and Vasa previa and I depended on the most famous obstetric and gynecological books, Like:
1-An evidence-based text for MRCOG, THIRD EDITION. 2016
2-Bedside Obstetrics and Gynecology (2010)
3-Differential_Diagnosis_in_Obstetrics and gynecology
And other books
Placenta previa
This document provides information on placenta previa, including its definition, pathogenesis, risk factors, classification, placental migration, clinical features, diagnosis, localization, management, complications, distinguishing features from abruption placentae, and thank you message at the end. Placenta previa is defined as when the placenta implants partially or completely over the lower uterine segment. The placenta normally implants in the upper uterine fundus but can implant lower due to suboptimal decidualization or blood supply, or a large placenta in multifetal pregnancies. Ultrasound is the primary diagnostic tool and most placenta previa diagnosed in the second trimester will migrate by term, with management including expect
Antepartum Hemorrhage(APH)
Under the topic of (APH) I talked about the most common causes of (APH) which are placental causes, including Placental Abruption, Placenta Previa and Vasa previa and I depended on the most famous obstetric and gynecological books, Like:
1-An evidence-based text for MRCOG, THIRD EDITION. 2016
2-Bedside Obstetrics and Gynecology (2010)
3-Differential_Diagnosis_in_Obstetrics and gynecology
And other books
Placenta previa
This document provides information on placenta previa, including its definition, pathogenesis, risk factors, classification, placental migration, clinical features, diagnosis, localization, management, complications, distinguishing features from abruption placentae, and thank you message at the end. Placenta previa is defined as when the placenta implants partially or completely over the lower uterine segment. The placenta normally implants in the upper uterine fundus but can implant lower due to suboptimal decidualization or blood supply, or a large placenta in multifetal pregnancies. Ultrasound is the primary diagnostic tool and most placenta previa diagnosed in the second trimester will migrate by term, with management including expect
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- 2. TOPIC: PLACENTA PRAEVIA Presented by: Dr. Bijit Talukdar Intern Doctor Unit-III Dept. of Obstetrics & Gynaecology
- 3. PLACENTA PRAEVIA When the placenta is implanted partially or completely over the lower uterine segment, it is called placenta praevia.
- 4. CAUSES OF PLACENTA PRAEVIA: Dropping down theory. Persistence of chorionic activity. Defective decidua. Big surface area of the placenta.
- 5. PREDISPOSING FACTORS : Multiparity Maternal age: >35 years Race: Asian women Infertility treatment Presence of uterine scar Prior curettage Prior placenta praevia Multiple pregnancy
- 6. TYPES: Type-I: Low lying Type-II: Marginal -Anterior -Posterior Type-III: Incomplete or partial central Type-IV: Complete Or central Clinically: Mild degree: I & II ant. Major degree: II post. III & IV
- 7. DANGEROUS TYPE OF PLACENTA PRAEVIA Type II posterior placenta praevia Cause- 1. Because of the curved birth canal major thickness of placenta overlies the sacral promontory, thereby diminishing the antero-posterior diameter of the inlet & prevents engagement of the presenting part. This hinders effective compression of the separated placenta to stop bleeding. 2. Placenta is more likely to be compressed if vaginal delivery is allowed. 3. More chance of cord compression or prolapse which may produce fetal anoxia or even death.
- 9. CAUSE OF BLEEDING: Placental growth slows on later months of pregnancy, but the lower uterine segment progressively dilates. Placenta gets separated due to shearing effect. Maternal sinuses become open up Bleeding occurs
- 10. MANAGEMENT OF PLACENTA PRAEVIA Diagnosis: Clinical features: Symptoms: Sudden onset , painless, apparently causeless & recurrent bleeding. Signs: General examination: General condition & anaemia are proportionate to visible blood loss. Abdominal Examination: Size of uterus: proportionate to the period of gestation. Feel of uterus: Soft, relaxed & elastic without any localised area of tenderness. Malpresentaion: Berech or transverse or unstable lie is more frequent. Fetal head: High floating FHS: Usually present
- 11. Vulval inspection: To see whether the bleeding is still occurring or not. Character of blood: Bright red Investigation: Confirmation of diagnosis: USG of Pregnancy profile Others: Hb% Blood grouping & Rh typing & cross matching RBS
- 12. TREATMENT: Expectant treatment: 1. Hospitalization 2. Wide bore IV cannula 3. IV fluid 4. Blood transfusion after grouping & cross matching 5. Iron & folic acid 6. Catheterization 7. Close follow up
- 13. DEFINITIVE TREATMENT: Termination of pregnancy. According to the type of placenta praevia: A) Type I & Type II anterior: Normal vaginal delivery ( If maternal & fetal condition is good) B) Type II posterior, Type III & Type IV: Caesarean section
- 14. COMPLICATIONS: Maternal Complication: During pregnancy: 1. APH with varying degrees of shock. 2. Malpresentation 3. Premature labour During labour: 1. Early rupture of membrane 2. Cord prolapse 3. Intrapartum Haemorrhage 4. Post partum haemorrhage 5. Retained placenta
- 15. During Puerperium: 1. Puerperal sepsis 2. Subinvolution 3. Embolism Fetal Complication: 1. Low birth weight 2. Fetal growth restriction 3. IUFD 4. Asphyxia 5. Birth injury 6. Congenital Malformation
- 16. THANK YOU