eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology

Placenta Previa: Follow-up

Author: Patrick Ko, MD, Clinical Assistant Professor, Department of Emergency Medicine, New York University Medical School; Assistant Program Director, Department of Emergency Medicine, North Shore University Hospital
Coauthor(s): Young Yoon, MD, Associate Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai Medical Center
Contributor Information and Disclosures

Updated: Aug 10, 2009

Follow-up

Further Inpatient Care

  • Bed rest in the hospital may be recommended for some women with bleeding caused by placenta previa.
  • A select population of women may be eligible for outpatient management.

Deterrence/Prevention

  • Patients with placenta previa should decrease activity to avoid rebleeding.
  • Pelvic examinations and intercourse should be avoided.
  • Some women will bleed and possibly go into labor without any inciting cause.

Complications

  • Maternal mortality (rare)
  • Rebleeding
  • Intrauterine growth retardation (IUGR)
  • Congenital anomalies
  • Fetal anemia and Rh isoimmunization

Prognosis

  • Patients with complete placenta previa tend to have poorer pregnancy outcomes. They tend to deliver more prematurely and may require hysterectomies at the time of delivery.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Instruments or fingers should not be placed near the cervix during a vaginal examination because uncontrolled bleeding can result. Do not perform vaginal or rectal examinations in the ED.
 


More on Placenta Previa

Overview: Placenta Previa
Differential Diagnoses & Workup: Placenta Previa
Treatment & Medication: Placenta Previa
Follow-up: Placenta Previa
Multimedia: Placenta Previa
References
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References

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  2. Milosevic J, Lilic V, Tasic M, Radovic-Janosevic D, Stefanovic M, Antic V. [Placental complications after a previous cesarean section]. Med Pregl. May-Jun 2009;62(5-6):212-6. [Medline].

  3. [Guideline] Royal College of Obstetricians and Gynaecologists (RCOG). Placenta praevia and placenta praevia accreta: diagnosis and management. Oct 2005;[Full Text].

  4. [Guideline] Oppenheimer L. Diagnosis and management of placenta previa. J Obstet Gynaecol Can. Mar 2007;29(3):261-73. [Medline]. [Full Text].

  5. Ananth CV, Smulian JC, Vintzileos AM. The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol. May 2003;188(5):1299-304. [Medline].

  6. Besinger RE, Moniak CW, Paskiewicz LS, Fisher SG, Tomich PG. The effect of tocolytic use in the management of symptomatic placenta previa. Am J Obstet Gynecol. Jun 1995;172(6):1770-5; discussion 1775-8. [Medline].

  7. Crane S, Chun B, Acker D. Treatment of obstetrical hemorrhagic emergencies. Curr Opin Obstet Gynecol. Oct 1993;5(5):675-82. [Medline].

  8. Dola CP, Garite TJ, Dowling DD, Friend D, Ahdoot D, Asrat T. Placenta previa: does its type affect pregnancy outcome?. Am J Perinatol. Oct 2003;20(7):353-60. [Medline].

  9. Gidiri M, Noble W, Rafique Z, Patil K, Lindow SW. Caesarean section for placenta praevia complicated by postpartum haemorrhage managed successfully with recombinant activated human coagulation Factor VIIa. J Obstet Gynaecol. Nov 2004;24(8):925-6. [Medline].

  10. Glynn JC, Plaat F. Prothrombin complex for massive obstetric haemorrhage. Anaesthesia. Feb 2007;62(2):202-3. [Medline].

  11. Iyasu S, Saftlas AK, Rowley DL, Koonin LM, Lawson HW, Atrash HK. The epidemiology of placenta previa in the United States, 1979 through 1987. Am J Obstet Gynecol. May 1993;168(5):1424-9. [Medline].

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Further Reading

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Keywords

placenta previa, disseminated intravascular coagulopathy, vaginal bleeding, pregnancy complications, obstetric complications, total placenta previa, partial placenta previa, marginal placenta previa, low-lying placenta previa, internal cervical os, abnormal placental implantation, uterine bleeding, treatment, diagnosis

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Contributor Information and Disclosures

Author

Patrick Ko, MD, Clinical Assistant Professor, Department of Emergency Medicine, New York University Medical School; Assistant Program Director, Department of Emergency Medicine, North Shore University Hospital
Patrick Ko, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Young Yoon, MD, Associate Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai Medical Center
Young Yoon, MD is a member of the following medical societies: Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Joseph J Sachter, MD, FACEP, Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center
Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Mark Zwanger, MD, MBA, Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University
Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association
Disclosure: Medicines Company Consulting fee Consulting; Pfizer Salary Employment

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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