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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.
In the Western world, maternal deaths due to placental abruption are rare. The fetal prognosis is worse than the maternal prognosis; approximately 12% of fetuses affected by placental abruption die. 77% of fetuses that die from placental abruption die before birth; the remainder die due to complications of preterm birth. [9]
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;
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...
Placenta previa is primarily diagnosed by ultrasound, either during a routine examination or following an episode of abnormal vaginal bleeding, often in the second trimester of pregnancy. Most diagnosis of placenta previa occurs during the second-trimester. [citation needed]
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]
Velamentous Placenta: Normal umbilical cord insertion and velamentous umbilical cord insertion in pregnancy, with and without vasa previa. Specialty: Obstetrics Symptoms: Blood vessel compression, [1] [2] decrease in blood supply to the fetus, [2] [3] impaired growth and development of the fetus. [4] [5] Risk factors
Risk factors include pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached. [1] Other risk factors include uterine atony, placenta previa, and connective tissue disorders. [1] Diagnosis is by seeing the inside of the uterus either in or coming out of the vagina. [2] [6]