Answer to OB/GYN Case #1

Answers

Diagnosis: placenta previa

Management: ultrasound

Risk factors: hypertension is NOT a risk factor

Discussion

Placenta previa is a condition where the placenta has attached over the cervical os and can be complete, partial, marginal, or low-lying depending on the position.

previa

The hallmark of placenta previa is painless, 2nd trimester bleeding.  Ultrasound should always be performed prior to any speculum or digital exam to limit the risk of bleeding.

Risk factors for placenta previa include :

Previous placenta previa

Previous cesarean delivery (risk increases with an increasing number of cesarean deliveries)

Multiple gestation

Multiparity

Advanced maternal age

Infertility treatment

Previous abortion

Previous intrauterine surgical procedure

Maternal smoking

Maternal cocaine use

Male fetus

Non-white race

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