Emergency Medical Minute21 Dec 2021

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD

Educational Pearls:

High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa
In placenta previa, the placenta implants over the cervix and this condition
- Often noted during routine prenatal care on transabdominal ultrasound
Patients present with painful vaginal bleeding, usually in the absence of trauma
Avoid pelvic exam, transvaginal ultrasound, or digital vaginal exam in placenta previa
Risk factors for placenta previa include multiple gestations, previous medical abortions, advanced maternal age, and previous placenta previa
Management usually includes admission to the hospital
- >37 weeks: admission for c-section
- 34-37 weeks: judgment call based on maternal/fetal stability
- <34 weeks: steroids for fetal lung maturation and delay delivery

References

Anderson-Bagga FM, Sze A. Placenta Previa. [Updated 2021 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539818/

Young JS, White LM. Vaginal Bleeding in Late Pregnancy. Emerg Med Clin North Am. 2019;37(2):251-264. doi:10.1016/j.emc.2019.01.006

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

*Image from BruceBlaus via Wikimedia Commons licensed under Creative Commons license

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