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Women with placenta previa often present with painless, bright red vaginal bleeding. This commonly occurs around 32 weeks of gestation , but can be as early as late mid-trimester. [ 8 ] More than half of women affected by placenta praevia (51.6%) have bleeding before delivery . [ 9 ]
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]
Placental abruption causes blood loss from the mother and loss of oxygen and nutrients to the placenta occasionally leading to preterm labour. [14] Other causes of placental abruption can be abdominal trauma or sudden decompression of amniotic fluid , however it is not uncommon for the cause of placental abruption to be unknown.
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]
Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [2] The condition was described at least as early as 1664. [7]
Causes of vaginal bleeding early in pregnancy include miscarriage (including inevitable, incomplete, or complete abortion), embryo implantation and growth outside the uterus (ectopic pregnancy), and placenta attachment at the bottom of the uterus over the cervix (placenta previa), all of which can cause significant bleeding.
In the second or third trimester a placenta previa (a placenta partially or completely overlying the cervix) may bleed quite severely. Placental abruption is often associated with uterine bleeding as well as uterine pain. [32] Vaginal bleeding during pregnancy can be normal, especially in early pregnancy. Light spotting early on in pregnancy ...
Postpartum bleeding, abdominal pain, mass in the vagina, low blood pressure [1] Types: First, second, third, fourth degree [1] Risk factors: Pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached, uterine atony, placenta previa, connective tissue disorders [1] Diagnostic method