Dec 21, 2021
Contributor: Peter Bakes, MD
Educational Pearls:
- High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa
- In placenta previa, the placenta implants over the cervix and this condition
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- Often noted during routine prenatal care on transabdominal ultrasound
- Patients present with painful vaginal bleeding, usually in the absence of trauma
- Avoid pelvic exam, transvaginal ultrasound, or digital vaginal exam in placenta previa
- Risk factors for placenta previa include multiple gestations, previous medical abortions, advanced maternal age, and previous placenta previa
- Management usually includes admission to the hospital
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- >37 weeks: admission for c-section
- 34-37 weeks: judgment call based on maternal/fetal stability
- <34 weeks: steroids for fetal lung maturation and delay delivery
References
Anderson-Bagga FM, Sze A. Placenta Previa. [Updated 2021 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539818/
Young JS, White LM. Vaginal Bleeding in Late Pregnancy. Emerg Med Clin North Am. 2019;37(2):251-264. doi:10.1016/j.emc.2019.01.006
Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD
*Image from BruceBlaus via Wikimedia Commons licensed under Creative Commons license
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