DEFINITION

Placenta previa is the abnormal implantation of the placenta in the

lower uterine segment, where it encroaches on the internal cervical
os.
As a result, the placenta is closer to the cervical os than to the
presenting part.
The three classifications of placenta (total, partial, and marginal)
depend on how much of the internal cervical os is covered by the
placenta.

WOMEN AT RISK
Women are at higher risk for placenta previa if they've had previous
surgeries involving the uterus, such as:
C-section
Surgery to remove uterine fibroids
Dilation and curettage, though this presents a much lower risk

CONTRIBUTING FACTORS
Placenta previa that persists beyond the 20th week of gestation can be due to abnormalities
of the uterus that promote attachment of the placenta in the lower regions of the uterus or to
factors that require an increased size of the placenta.
Multiparity
Uterine scars from previous Cesarian section
Induced or spontaneous abortions involving suction curettage
Advanced Maternal age (>35 years)
Cigarette smoking
Endometritis
Higher probability if the baby is male
Women who have had placenta previa in their previous pregnancy

SIGNS AND SYMPTOMS

The main symptoms of placenta previa usually produce painless, bright red vaginal bleeding
after the 20th week of gestation in pregnancy. This occurs from the tearing of the placental villi
from the uterine wall as the lower uterine segment thins and the internal os begins dilation
near term. However uterine pain and contractions do not preclude the diagnosis in a woman
who presents with vaginal bleeding. In many cases placenta previa remains asymptomatic
throughout pregnancy.