Placenta Previa

PBL Session.
Grp E
 Definition:
The presence of placental tissue overlying
or proximate to the cervical os.
Normally the placenta attaches to the
anterior or posterior surface of the uterus.
In placenta previa, it attaches to the lower
area of the uterus.
It is an obstetric complication in which
placenta is inserted partially or wholly in
the lower uterine segment.
 Types and Grades of
Placenta Previa:
Low Lying Placenta/ Grade I:
Placenta lies in the lower uterine segment but
its lower edge does not abut the internal
cervical os (i.e 0.5-5.0 cm from internal os.
Marginal Placenta/ Grade II:
Placental tissue reaches the margin of the
internal cervical os, but does not cover it.
Partial Previa/ Grade III:
Placenta partially covers the internal cervical os.
Complete Previa/ Grade IV:
Placenta completely covers the internal cervical
os.
* Sometimes types I and II are termed as
minor or partial placenta previa, and types
III and IV are termed as major placenta previa.
 DEPTH OF ATTACHMENT:
Placenta accreta :
The placenta attaches itself too deeply and too
firmly into the uterus.

Placenta increta :
The placenta attaches itself even more deeply into
the muscle wall of uterus.

Placenta percreta :
The placenta attaches itself and grows through the
uterus, sometimes extending to nearby organs, such
as the bladder.
 CAUSES
OF
PLACENTA PREVIA
 The fertilized egg implanted very low in the uterus, causing the placenta to form
close to or over the cervical opening.
The lining of the uterus (endometrium) has abnormalities such as fibroids or scarring
(from previous previa, incisions, caesarean sections or abortions).
The placenta formed abnormally.
The pregnancy is multiple (i.e., twins or triplets).
The mother may have had several previous pregnancies.
The mother smokes or uses cocaine.
The mother is older.(Above 35)
The pregnancy has been conceived with the help of assisted reproductive
technology, such as in-vitro fertilization.
RISKS AND
COMPLICATIONS
Complications in FETUS:
Slow fetal growth due to insufficient blood supply

Fetal anemia

Fetal distress due to low oxygen supply

Preterm Birth of the Baby

Complications in MOTHER:
Severe Intensive Bleeding

Shock and death of the mother if the

bleeding is excessive

Infection and formation of blood clots

Blood loss requiring transfusion

Low Hemoglobin level (due to loss of blood)