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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 praevia or vasa praevia refers to the placenta or fetal blood vessels, respectively, covering or being located close to the opening of the uterus. More than half of women affected by placenta praevia (51.6)% have bleeding before delivery. [12] Vasa praevia occurs in about 0.6 per 1000 pregnancies. [13]
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]
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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 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.
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 ...
VBAC, compared to vaginal birth without a history of Caesarean section, confers an increased risks for placenta previa, placenta accreta, prolonged labor, antepartum hemorrhage, uterine rupture, preterm birth, low birth weight, and stillbirth. However, some risks may be due to confounding factors related to the indication for the first ...