COMPLICATIONS OF PLACENTA PREVIA

1. Hemorrhage (antepartum and postpartum) (1).
2. Placenta accreta.
3. Placental abruption.
• 14 times more frequent than normal pregnancies.
• Fourfold increase in rate of cesarean section (1,2)
4. IUGR.

Because of the association between placenta previa and vasa previa, placenta accreta/increta/percreta and abnormal cord insetion (including succenturiate lobes), all patients with a low lying placenta at 18-22 weeks should receive an endovaginal scan to:

• Assess the relationship between the placental edge and cervix – if this is 1 cm or more we do not rescan the patients at 30-32 weeks.
• Assess the insertion of the cord.
• Exclude vasa previa.
• Assess the retroplacental venous plexus and boundary echogenic line to exclude placenta accreta.

REFERENCES

1. Taipale P, Hiilesmaa V, Ylostalo P. Diagnosis of placenta previa by transvaginal sonographic screening at 12-16 weeks in a nonselected population. Obstet Gynecol 1997;89:364-367.
2. Meshame PM, Heye PS, Epstein MF. Maternal and perinatal morbidity resulting from placenta previa. Obstet Gynecol 1985;65:176-182.