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Oyelese et al. found that 2/3 of patient with vasa previa at delivery had a low-lying placenta or placenta previa that resolved prior to the time of delivery. There are three types of vasa previa. Types 1 and 2 were described by Catanzarite et al. In Type 1, there is a velamentous insertion with vessels running over the cervix.
Vasa praevia is a very rare, presenting only 4:10,000 cases from the largest study of the condition. [16] Risks of antepartum bleeding due to vasa praevia greatly increase during the third trimester of pregnancy during cervical dilation or placenta praevia .
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 ...
The bleeding may be due to placental abruption, uterine rupture, placenta accrete, undiagnosed placenta previa, or vasa previa. [3] Cesarean section is indicated. Post-partum hemorrhage is defined by the loss of at least 1,000 mL of blood accompanied with symptoms of hypovolemia within 24 hours after delivery.
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Placenta praevia is when the placenta attaches inside the uterus but in a position near or over the cervical opening. [1] Symptoms include vaginal bleeding in the second half of pregnancy. [1] The bleeding is bright red and tends not to be associated with pain. [1]
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Risk factors such as diabetes, chronic blood pressure and multiple pregnancies can increase the risk of developing placental disease. [3] Also, exposure to sudden trauma can increase the risk of placental abruption which coincides with placental disease. [6] There is no target treatment available for placental disease.
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