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The following have been identified as risk factors for placenta previa: Previous placenta previa (recurrence rate 4–8%), [13] caesarean delivery, [14] myomectomy [10] or endometrium damage caused by D&C. [13] Women who are younger than 20 are at higher risk and women older than 35 are at increasing risk as they get older.
Placenta previa is a condition that occurs when the placenta fully or partially covers the cervix. [13] Placenta previa can be further categorized into complete previa, partial previa, marginal previa, and low-lying placenta, depending on the degree to which the placenta covers the internal cervical os.
The accumulating blood pushes between the layers of the decidua, pushing the uterine wall and placenta apart. When the placenta is separated, it is unable to exchange waste, nutrients, and oxygen, a necessary function for the fetus's survival. The fetus dies when it no longer receives enough oxygen and nutrients to survive. [9]
An impaired placenta cannot support the pregnancy and this may lead to the loss of a chromosomally normal baby. [5] On the other hand, an apparently normal diploid fetus may experience problems with growth or development due to the effects of uniparental disomy (UPD). Intrauterine growth restriction (IUGR) has been reported in a number of CPM ...
Placenta praevia refers to when the placenta of a growing foetus is attached abnormally low within the uterus. Intermittent antepartum haemorrhaging occurs in 72% of women living with placenta praevia. [6] The severity of a patient's placenta praevia depends on the location of placental attachment;
Ischemic placental disease leads to the attachment of the placenta to the uterine wall to become under-perfused, causing uteroplacental ischemia. Where the term overarches the pathology associated with preeclampsia , placental abruptions and intrauterine growth restriction (IUGR). [ 3 ]
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
If placenta previa is present at the time of delivery, vaginal delivery is contraindicated because the placenta is blocking the fetus's passageway to the vaginal canal. Herpes simplex virus with active genital lesions or prodromal symptoms is a contraindication for vaginal delivery so as to avoid mother-fetal transfer of HSV lesions.
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