Previous placenta

It is more frequent in women from 35 years.

• Uterine scars Prerequisites: the risk of presenting placenta previa increases with the number of prerequisites. Endometrial abnormalities from vigorous anterior curettage also increase the risk of placenta previa.
• Smoking: smoking women are at increased risk of placenta previa.
• Race: It is more common in black or Asian women than in white women.
• Gestational age: the incidence of placenta previa changes with the time of pregnancy. Low insertion placenta previa is more frequent the lower the gestational age, as gestation advances in most cases it resolves.

Symptoms

The most typical symptom of placenta previa is painless bleeding of bright red blood which can be scarce or abundant. Bleeding episodes tend to recur and may increase in intensity as pregnancy progresses. Bleeding episodes do not usually have fetal repercussions unless the bleeding is so profuse that it produces hypovolemic shock3 in the mother.

Treatment

Diagnosis is made by ultrasound It can be abdominal but the transvaginal one is safer and more reliable in its diagnosis. The treatment of the placenta previa It depends of various factors. The main one is the time of pregnancy since in the case of a full-term pregnancy, the treatment is the end of the pregnancy.

In preterm pregnancies, the attitude should be conservative and expectant while the mother and fetus are not at risk. Fetal lung maturation is then carried out with intramuscular treatment with corticosteroids. If there is a deterioration in the maternal or fetal state despite being a premature birth, the fetal extraction should be carried out.

The route of delivery depends on the type of placenta previa and several clinical considerations. Total occlusive placenta is a contraindication for vaginal delivery. In the other cases, it depends on the evolution and the specialist is the one who decides which is the most appropriate type of delivery for each case.