Define Placenta Previa and its etiology ,types Clinical features & management.

Description :- Placenta Previa
Definition :- Its is type of ante-partum hemorrhage. When the placenta is implanted partially or completely over the lower uterine segment , it is called Placenta previa.
Etiology :-
(1) The exact cause of implantation of placenta is unknown .
(2) Dropping Down Theory
(3) Persistence of chorionic activity in deciduas capsularis
(4) Big surface area of placenta
(5) Multiparity
(6) Increase maternal age
(7) History of previous cessarion section or scar in uterus
(8) Prior curettage use
Types :- There are four types of placenta previa .
(1) Type 1st( low lying ) – Major part of placenta is attached to upper segment & only margin reach on to lower segment but not up to os.
(2) Type 2nd (marginal ) – Placenta reach to margin of internal os but doesn’t cover it .
(3) Type 3rd ( Incomplete or partial central ) – Placenta cover the internal os partially .
(4) Type 4th (central or total ) – Placenta completely cover the internal os .

Clinical Features :- (1) Vaginal Bleeding
(2) Bleeding painless
(3)Bleeding is causeless & recurrent
(4) Anemic due to visible blood loss
Diagnosis :- –Sonography
–Magnetic resonance imaging
Management :- The following guidelines are useful to minimize the risk-
-Adequate antenatal care
– Antenatal diagnosis
– Significance of “Warning Hemorrhage ‘’ should not be ignored
Management at home :-
-Patients is immediately put to bed .
-To assess the blood loss .
-Note the pulse ,BP , & degree of anemia .
-Quick gentle abdominal examination .
-Vaginal examination must not be done .
Management in hospital :-
-Treatment depend on duration of pregnancy, fetal & maternal status & extend of hemorrhage .
-To give advice to pts for supplement therapy .
– Encourage the pts for steroid therapy .
– Vaginal delivery would be considered only in type 1& 2 placenta previa .