Placenta Previa

Major complication of placenta previa is

A. Postpartum hemorrhage
B. Requires the delivery by cesarean delivery
C. Increase a woman’s risk for placenta accreta spectrum (PAS)
D. Prematurity

All are risk factors for placenta previa except

A. Women under 20 yrs
B. Smoking, cocaine use
C. Prior suction, and curettage
D. Assisted reproductive technology

Follow up sonogram for low lying placenta is recommended at

A. After 2 weeks
B. Before delivery
C. 32 to 36 weeks
D. Between 28 to 32 weeks of gestation

Not true of placenta previa management

A. Women with a major degree of placenta previa and an episode of bleeding be hospitalized from 34 weeks
B. Precautionary uterine artery catheters can be placed before cesarean delivery
C. Women with excessive or continuous vaginal bleeding should be delivered via cesarean section regardless of gestational age.
D. Regional anesthesia is considered superior to general anesthesia

All are causes of antepartum hemorrhage in placenta previa except

A. Cervical varices and sponge like cervix
B. Presence of marginal sinus
C. Long cervix with complete placenta previa
D. Low-lying placenta with a thick edge

All of the following findings indicate placenta accreta spectrum except

A. A Swiss cheese-like appearance of placenta in ultrasonography
B. Thinning (≤1 mm) of the myometrium
C. Color-Doppler and pulse-Doppler ultrasonography shows lacunar flow in the placenta
D. Low α-fetoprotein levels

In short

  • Slowing of the fetal heart rate on pressing the head down into the pelvis which soon recovers promptly as the pressure is released is suggestive of the presence of low lying placenta especially of posterior type is known as Stallworthy’s sign.

  • The neonate is at increased risk of preterm birth, lower birth weight, lower APGAR scores, and increased risk for respiratory distress syndrome.

  • Use of cervical cerclage to reduce bleeding and to prolong pregnancy is not helpful

  • Vaginal delivery may be considered where the placenta edge is clearly 2–3 cm away from the internal cervical os (based on sonography).

  • If hemostasis by sutures fails and the uterus is to be preserved using B-Lynch suture.

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