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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.
Pelvimetry is the measurement of the female pelvis. [1] It can theoretically identify cephalo-pelvic disproportion, which is when the capacity of the pelvis is inadequate to allow the fetus to negotiate the birth canal.
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.
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 ...
Before the placenta is delivered there is a gush of blood as the cord gets longer. [24] [22] The umbilical cord can be held taut, but must not be pulled with much force. [24] The placenta is delivered and is inspected for completeness. The placenta should be stored in a bag for inspection by trained medical personnel. [24] [17]
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.
Anatomy scan image of a human placenta and umbilical cord (colour Doppler rendering) showing central placement of the cord in the placenta and three vessels in the cord, which is the normal physiology. A standard anatomy scan typically includes: [4] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations