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Placenta Previa

Katie Coble, MD and Vanessa M Garcia-Turner, MS, MBA, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Complete/total previa: Placenta covers the entire os.

  • Partial previa: Placenta covers part of internal cervical os.

  • Marginal previa: Placental edge is adjacent to cervical os by ultras...

DIAGNOSIS

HISTORY

  • Painless vaginal bleeding seen in 70–80% of cases

  • Initial bleeding seen prior to 30 weeks in almost 1/3 of pregnancies

  • Placenta previa is commonly identified during routine dating and a...

TREATMENT

GENERAL MEASURES

  • Avoid vaginal intercourse and strenuous exercise in women with previa after 20 weeks.

  • Avoid vaginal exams, douching, or other vaginal manipulation.

  • Rh-negative women should rec...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Repeat US of placenta location if last US was done at <37 weeks’ gestational age.

  • Placentae should be sent for pathologic evaluation.

DIET

No restrictions once st...

REFERENCES

1
Dola  CP. Diagnosis and safe management of placenta previa. OBG Manag.  2006;18(10):77–95. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

Advanced Life Support in Obstetrics. Vaginal bleeding in late pregnancy. http://www.tomwademd.net/advanced-life-support-in-obstetrics-also-vaginal-bleeding-in-l...

CODES

ICD10

  • O44.11 Complete placenta previa with hemorrhage, first trimester

  • O44.03 Complete placenta previa NOS or without hemorrhage, third trimester

  • O44 Placenta previa

  • O44.00 Complete placenta previa ...

CLINICAL PEARLS

  • Placenta previa is a major cause of vaginal bleeding in the 2nd and 3rd trimesters.

  • Many pregnancies diagnosed with placenta previa will have resolution by term.

  • Do not perform digital c...

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