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Placenta praevia

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

A condition in which the placenta is partially or wholly implanted in the lower uterine segment on either the anterior or posterior wall.

 

Figure 1. Type 1                                                     Figure 2. Type 2 

 

Type 1. (Figure 1)

  • The majority of the placenta is in the upper uterine segment
  • Blood loss is usually mild and the mother and fetus remain in good condition
  • Vaginal birth is possible

Type 2. (Figure 2)

  • The placenta is partially located in the lower segment near the internal cervical os
  • Blood loss is usually moderate, although the conditions of the mother and fetus can vary
  • Vaginal birth is possible, particularly if the placenta is anterior

 

 

Figure 3. Type 3                                                  Figure 4. Type 4                                                                                                      

Type 3. (Figure 3)

  • The placenta is located over the internal cervical os but not centrally
  • Bleeding is likely to be severe
  • Vaginal birth is inappropriate

Type 4. (Figure 4)

  • The placenta is located centrally over the internal cervical os
  • Torrential haemorrhage is very likely
  • Caesarean section is essential

     

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