Podcast 740: Placenta Previa

<p><strong>Contributor: Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">In placenta previa, the placenta implants over the cervix and this condition</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Often noted during routine prenatal care on transabdominal ultrasound</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Patients present with painful vaginal bleeding, usually in the absence of trauma</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Avoid pelvic exam, transvaginal ultrasound, or digital vaginal exam in placenta previa</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Risk factors for placenta previa include multiple gestations, previous medical abortions, advanced maternal age, and previous placenta previa</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Management usually includes admission to the hospital</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">>37 weeks: admission for c-section</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">34-37 weeks: judgment call based on maternal/fetal stability</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;"><34 weeks: steroids for fetal lung maturation and delay delivery </span></li> </ul> </li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Anderson-Bagga FM, Sze A. Placenta Previa. [Updated