Placenta previa is the implantation of the placenta over the internal cervical os (uterine opening). Placenta previa can be complete (covering the entire uterine opening) or partial (covering just a portion of the uterine opening). A marginal placenta is when the edge of the placenta approaches the opening of the uterus and a low-lying placenta is when the placental edge is within 2-3 centimeters from the uterine opening. A placenta previa diagnosed during the first trimester of pregnancy can self-correct and disappear as the uterus grows with the pregnancy.
Placenta previa is a leading cause of bleeding during the last six months of pregnancy and classically presents as painless bright red bleeding. Sometimes, the vaginal bleeding can be associated with uterine irritability. The exact cause of placenta previa is unknown. Risk factors associated with placenta previa include:
Advancing age (35 years)
History of dilatation and curettage of the uterus
Prior placenta previa
Tests used to evaluate placenta previa include:
Vaginal or Abdominal ultrasound
Ultrasound assessment of the baby
CBC (complete blood count)
Blood type evaluation
Test for fetal lung maturity
Tests to rule out fetal origin of the vaginal bleeding
Expectant management until fetal maturity is accomplished has routinely been used for patients with placenta previa. Cesarean section is the safest mode of delivery. At times, the placenta previa may attach directly into the uterine muscle creating what is known as Placenta acreta, increta or percreta in accordance with the degree of uterine penetration. Patients with complete placenta previa tend to deliver prematurely and at times may require hysterectomy following delivery. The surgical team must be prepared for potential complications associated with placenta previa. Complications associated with placenta previa include:
Abnormal fetal presentation
The obstetrical team caring for a patient with placenta previa must have delivery plans that include matched-blood and the possibility of cesarean hysterectomy (delivery of the infant followed by removal of the uterus) because of continuous bleeding.
If the child's injury was the result of intrauterine fetal hypoxia (asphyxia or birth trauma), that was diagnosable, avoidable and preventable, you may have a valid cause of action. The injury may be the result of a medical provider's mistake in handling an obstetrical condition. Your child and you as parents of the child are entitled to receive compensation. If your child's condition was the result of medical negligence, allow Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten help you assert your rights and get the compensation you deserve.
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