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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 ]
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]
One theory is that velamentous cord insertion may arise from the process of placental trophotropism, which is the phenomenon where the placenta migrates towards areas which have better blood flow with advancing gestation. The placenta grows in regions with better blood supply and portions atrophy in regions of poor blood flow.
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]
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.
On 5 December 2010, Kay began to perform a caesarean on a patient who had undiagnosed placenta praevia. Kay first delivered the placenta and then the baby, which was dead and unable to be resuscitated. The detached placenta caused heavy haemorrhaging; Kay and the senior consultants called into theatre failed to stop the bleeding and, after 2 ...
Immediately after delivery, the fundus of the uterus begins to contract. This is to deliver the placenta which can take up to 30 minutes and may involve a feeling of chills. [8] In a normal and healthy response it should feel firm and not boggy. It begins to involute with contractions of the smooth muscle of the uterus. It will contract midline ...
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 ...