Management of placenta previa
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- Karen Russo-Stieglitz, MD
Karen Russo-Stieglitz, MD
- Consulting Perinatologist
- Morristown Medical Center
- Section Editors
- Deborah Levine, MD
Deborah Levine, MD
- Section Editor — Imaging
- Professor of Radiology
- Director of Ob/Gyn Ultrasound
- Department of Radiology
- Beth Israel Deaconess Medical Center
- Susan M Ramin, MD
Susan M Ramin, MD
- Section Editor — Obstetrics
- The American Board of Obstetrics and Gynecology (ABOG)
The management of pregnancies complicated by placenta previa is best addressed in terms of the clinical setting: asymptomatic women, women who are actively bleeding, and women who are stable after one or more episodes of active bleeding.
ASYMPTOMATIC PLACENTA PREVIA
The management goals in women with asymptomatic placenta previa are to:
●Determine whether the previa resolves with increasing gestational age
●Reduce the risk of bleeding
●Reduce the risk of preterm birth
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- ASYMPTOMATIC PLACENTA PREVIA
- Follow-up transvaginal ultrasound examination
- Prediction of and reduction of risk of bleeding
- ACUTE CARE OF BLEEDING PLACENTA PREVIA
- - Maternal
- - Fetal
- - Laboratory
- Anti-shock garments
- Intravenous access and crystalloid
- Magnesium sulfate
- Antenatal corticosteroids
- Indications for delivery
- CONSERVATIVE MANAGEMENT AFTER AN ACUTE BLEED
- Inpatient versus outpatient management
- Correction of anemia
- Autologous blood donation
- Anti-D immune globulin
- Fetal assessment
- Preterm premature rupture of membranes
- - Timing
- - Route
- Low placenta
- - Cesarean procedure
- Management of hemorrhage
- - Vasopressin
- PREGNANCY TERMINATION IN WOMEN WITH PLACENTA PREVIA
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS
- Asymptomatic previa
- Acute management of bleeding previa
- Conservative management after an acute bleed