Friday, September 16, 2011
Placenta Previa
7:34 AM | 
Posted by
Arif Siregar
Definition
In placenta previa, the placenta is located over or very close to the internal os. Known there are four degrees of this disorder:
1) Placenta previa totalis
The internal cervical os completely covered by the placenta.
2) placenta previa parsialis
Partially closed internal os by the placenta.
3. Placenta previa marginalis
Placental edge lies in the limits of the internal os.
4. The placenta lies low
The placenta is embedded in the lower uterine segment such that the placenta edge actually does not reach the internal os but is very close to him.
Other circumstances, called vasa previa, is the state with fetal vessels running through the amniotic membranes and contained in the internal os. This condition is a rare cause of bleeding anterpartum and has a high fetal mortality. Prenatal diagnosis with ultrasonography improve perinatal prognosis.
Etiology
Incidence increases with advanced maternal age, multiparity, history of cesarean section, and smoking.
Diagnosis
Diagnosis of placenta previa can seldom be ascertained by clinical examination, except when a finger is inserted through the cervix and placenta palpable. Cervical examination like this should not be done unless the woman concerned was on the operating table with all preparations for immediate cesarean section because even the most careful examination of the liver can cause massive bleeding. In addition, this examination is rarely done, except if it had been planned to give birth, because bleeding can occur in such a way that the fetus needs to be born, although still immature. Examination "double set-up" is rarely necessary because the location of the placenta is almost always can be identified by ultrasound.
1) Placenta previa totalis
The internal cervical os completely covered by the placenta.
2) placenta previa parsialis
Partially closed internal os by the placenta.
3. Placenta previa marginalis
Placental edge lies in the limits of the internal os.
4. The placenta lies low
The placenta is embedded in the lower uterine segment such that the placenta edge actually does not reach the internal os but is very close to him.
Other circumstances, called vasa previa, is the state with fetal vessels running through the amniotic membranes and contained in the internal os. This condition is a rare cause of bleeding anterpartum and has a high fetal mortality. Prenatal diagnosis with ultrasonography improve perinatal prognosis.
Etiology
Incidence increases with advanced maternal age, multiparity, history of cesarean section, and smoking.
Diagnosis
Diagnosis of placenta previa can seldom be ascertained by clinical examination, except when a finger is inserted through the cervix and placenta palpable. Cervical examination like this should not be done unless the woman concerned was on the operating table with all preparations for immediate cesarean section because even the most careful examination of the liver can cause massive bleeding. In addition, this examination is rarely done, except if it had been planned to give birth, because bleeding can occur in such a way that the fetus needs to be born, although still immature. Examination "double set-up" is rarely necessary because the location of the placenta is almost always can be identified by ultrasound.
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