前置胎盘英文课件.pptVIP

Placetal Previa Long Xiaoyu 龙晓宇 XuanWu Hospital 宣武医院 Case 1. 30 G3P2 at 32 weeks’ gestation, painless vaginal bleeding. Four weeks ago , postcoital vaginal spotting 2. BP:110/70mmHg ,abdomen is soft uterus nontender , FHR :140-150bpm Case 1 What is most likely diagnosis? What is your next step? Long-term management of this patient? What are the most common causes of Antepartum Hemorrhage ? COMMON CAUSES Placenta Previa Placental Abruption Preterm labor UNCOMMON CAUSES Uterine rupture Fetal(chorionic ) vessel rupture Cervical or vaginal lacerations Cervical or vaginal lesions, including cancer Congenital bleeding disorder Unknown ( by exclusion of the above) Placental Previa Understand that placenta previa and placental abruption are major causes of antepartum hemorrhage Know the painless vaginal bleeding is consistent with placenta previa Understand that the ultrasound examination is a good method for assessing placental location Objectives Defined as the inferior edge of placenta load at the lower uterine segment, or even reach the internal cervical os after 28 weeks gestation. Incidence rate: Internal：0.24%~1.57%； International：0.5%~0.9%。 Placental Previa “ the placenta overlying the internal os of the cervix” Classification Classification Complete(central ) placenta previa Partial placenta previa Marginal placenta previa Low-lying placenta previa What are the risk factors for placental Previa? Question ETIOLOGY Increased maternal age Uterine factors: Previous CS Instrumentation of the uterine cavity (D and C for miscarriages or Induced Abortions) Placental factors: Multiparity Multiple gestation Prior placenta previa ETIOLOGY Manifestation It characteristically presents with unprovoked and repeated painless vaginal bleeding. Clinical Presentation Manifestation The classification of previa placenta sometimes determines the occurrence period and the volume of losing blood. To