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.

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.

http://www.pregmed.org

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