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At least 19 recordsLinked to original sources
PubMed1978

The identification of placenta praevia.

Placenta praevia is frequently misdiagnosed because of an overdistended bladder at the time of ultrasound examination. Other incorrectly diagnosed cases may be related to placental migration due to the result of differential growth of the uterus and placenta. By recognizing these potential errors, the ultrasound diagnostic accuracy of placenta praevia will improve.

Diagnostic Errors↗
PubMed2000

Interventions for suspected placenta praevia.

BACKGROUND: Because placenta praevia is implanted unusually low in the uterus, it may cause major, and/or repeated, antepartum haemorrhage. The traditional policy of care of women with symptomatic placenta praevia includes prolonged stay in hospital and delivery by caesarean section. OBJECTIVES: To assess the impact of any clinical intervention applied specifically because of a perceived likelihood that a pregnant woman might have placenta praevia. SEARCH STRATEGY: A comprehensive electronic search was performed to identify relevant literature. Searched databases included the Trials Register maintained by the Cochrane Pregnancy and Childbirth Group, and the Cochrane Controlled Clinical Trials Register. SELECTION CRITERIA: Any controlled clinical trial that has assessed the impact of an intervention in women diagnosed as having, or being likely to have, placenta praevia. DATA COLLECTION AND ANALYSIS: Data were extracted from the three identified trial reports, unblinded, by the author without consideration of results. MAIN RESULTS: Two comparisons could be made - home versus hospitalisation and cervical cerclage versus no cerclage. Both were associated with reduced lengths of stay in hospital antenatally. Otherwise, there was little evidence of any clear advantage or disadvantage to a policy of home versus hospital care. Cervical cerclage may reduce the risk of delivery before 34 weeks, or the birth of a baby weighing less than 2 kg or having a low 5 minute Apgar score. In general, these possible benefits were more evident in the trial of lesser methodological quality. REVIEWER'S CONCLUSIONS: There are insufficient data from trials to recommend any change in clinical practice. Available data should, however, should encourage further work to address the safety of more conservative policies of hospitalisation for women with suspected placenta praevia, and the possible value of insertion of a cervical suture.

Female↗
PubMedDate not supplied

[Associated placenta praevia and placenta accreta. Clinical case].

Personal experience of a case of placenta praevia and accreta is reported. In agreement with other authorities, it is thought that since the condition is not immediately apparent, it should always be suspected when hemorrhaging occurs in the 7th-9th month of pregnancy. It is also confirmed that rapid diagnosis and radical treatment will generally prevent serious problems.

Adult↗
PubMed1981

Placenta praevia accreta.

Placenta praevia accreta is a rare life-threatening complication of pregnancy. Four cases are presented from one hospital over a period of 10 years in which there were 36 608 deliveries, an incidence of one in 9152 (0.011%). In all cases there was a successful outcome for both mother and baby, despite different forms of management.

Adult↗
PubMed1994

Risk factors for placenta praevia.

Risk factors for placenta praevia have been analysed in a case control study conducted in Milan, Italy. A total of 140 cases of placenta praevia and the two women who delivered healthy babies consecutively after each index case (280 controls) were identified reviewing clinical records of 49,765 registered deliveries at the Clinica Mangiagalli in Milan from 1979 to 1991. An increased relative risk (RR) of per cent confidence interval, CI, 2.3-6.7) and among those with previous abortions (RR = 1.8, 95 per cent CI, 1.2-2.8) or with more than one previous pregnancy (RR = 1.9, 95 per cent CI, 1.1-3.3). A non-significant trend in risk was observed with parity (RR = 1.2 for one and 1.5 for two previous deliveries versus nulliparas) and for caesarean section (RR = 1.2 for one and 2.1 for two previous caesarean deliveries versus no previous caesarean section). No relation emerged with sex of the newborn and multiple pregnancy and risk of placenta praevia. Our study shows that older age and previous abortions are associated with an increased frequency of placenta praevia.

Adult↗
PubMed1993

Placenta praevia and accreta after previous caesarean section.

A prospective study was undertaken to determine the relationship between previous caesarean section (CS), placenta praevia and placenta praevia accreta. Of 41,206 consecutive deliveries 1851 had had previous caesarean section and 222 had placenta praevia. Of the cases of placenta praevia, 175 occurred in the uterus and 47 occurred after previous CS. Placenta praevia complicated 2.54% of cases with a previous caesarean section compared with 0.44% of cases with no scar--a 5-fold increase. In patients with placenta praevia occurring with a previous scar, 18 were complicated by placenta accreta (38.2%) compared with only 8 (4.5%) in unscarred uteri. After one caesarean section, placenta praevia was complicated by accreta in 10% of cases and after two or more this was 59.2%. The risk of hysterectomy with placenta praevia and uterine scar was 10% but with placenta praevia accreta it was 66%. There was one maternal death in the placenta praevia accreta group.

Cesarean Section↗
PubMed1998

Placenta praevia and accreta: analysis of a two-year experience.

OBJECTIVE: Our purpose was to determine the relationship between previous caesarean section and subsequent development of placenta praevia and placenta praevia with accreta. METHOD: A retrospective review of the case records of all women delivered with the diagnosis of placenta praevia during the 2-year period from January 1, 1995, to December 31, 1996, at the tertiary referral centre, Princess Badeea Teaching Hospital, in north Jordan. RESULTS: There were 18, 651 deliveries in the study period. 65 (0.35%) had placenta praevia, 21 (32.3%) of whom had a history of previous caesarean section. The incidence of placenta praevia was significantly increased in those with a previous caesarean section (1.87%) compared with those with an unscarred uterus (0.25%); p < 0.0001). This risk increased as the number of previous caesarean sections increased: 1.78% for one previous section; 2.4% for two, and 2.8% for three or more. The incidence of anterior placenta praevia and placenta accreta was significantly increased in those with previous caesarean scars. In the group without antecedent of caesarean section, accretism risk was 9%, with one section or more 40.8% (p < 0.005). CONCLUSION: There is a high association between anterior placenta praevia, placenta accreta and previous caesarean section. This was enhanced with the increasing number of previous caesarean sections. Patients with an antepartum diagnosis of placenta praevia who have had a previous caesarean section should be considered at high risk of developing placenta praevia and accreta.

Cesarean Section↗
PubMed1999

Conservative management of a case of placenta praevia percreta.

Pregnancies complicated by placenta praevia and a history of caesarean section are associated with increased risk of placenta percreta (1). Placenta praevia percreta sometimes involves the bladder or other pelvic organ, invasion leading to genital bleeding or haematuria (2, 3). Bladder injury or uncontrollable profuse haemorrhage occasionally occurs in such patients during surgery. Examination of placental invasion is necessary as this clinical condition is severe. Treatment of placental myometrium invasion is required to prevent uncontrollable profuse haemorrhage during surgery. We present a multiparous patient who was diagnosed prenatally with placenta praevia percreta using magnetic resonance imaging (MRI) and who was treated conservatively with a good prognosis.

Adult↗
PubMed1977

Ultrasonic diagnosis of placenta praevia.

741 women suspected of placenta praevia were submitted to ultrasonic scanning during the second and/or third trimesterr of pregnancy. In 61 an abnormal placental site was diagnosed. During Caesarean section, carried out in 46 of these cases, the location was compared with the ultrasound findings. The scanning diagnosis during the last trimester correlated with the findings at delivery. At scanning after the 35th week the diagnosis differed in only 4 cases. In all 4 there was a question of a low-lying placenta versus partial placenta praevia. During the second trimester diagnosis of low-lying placenta were revised in several cases at later scans. It is discussed whether these early diagnoses of an abnormal placental site, which later becomes normal, indicate a migrating placenta and/or an uncertainty of the scanning method. Early diagnosis of low-lying placentae should be checked by repeat scans.

Cesarean Section↗
PubMed1994

Do women with placenta praevia without antepartum haemorrhage require hospitalization?

Patients with placenta praevia in the third trimester are routinely confined to hospital for fear of major haemorrhage. Whilst this is arguably necessary for those who have had an episode of antepartum haemorrhage (APH), it is uncertain whether these same management principles are valid for those with placenta praevia without antepartum haemorrhage. A retrospective study was undertaken reviewing the case records of 69 consecutive patients diagnosed with placenta praevia in the third trimester of pregnancy. The outcome of 15 who had had no episodes of bleeding were compared with those who had at least 1 antepartum bleeding episode. Patients with placenta praevia without evidence of APH spent a significantly shorter amount of time in hospital and had a significantly lower rate of emergency delivery, with a neonatal outcome as good if not better than the APH group. We conclude that outpatient management in this cohort of patients may be a safe and cost-effective means of care, and warrants randomized prospective study.

Adult↗