Placenta Previa Abruptio Placenta

Placenta
Location

 Total placenta previa. The placenta

completely covers the cervix.

Placenta develops in the uterus
during pregnancy.

 Partial placenta previa. The placenta

is partially over the cervix.


 Marginal placenta previa. The

placenta is near the edge of the cervix.
Character of Bright red vaginal bleeding. Bleeding often
Bleeding occurs as the lower part of the uterus thins
during the third trimester of pregnancy in
preparation for labor. This causes the area of
The most common symptom of
placental abruption is dark red
vaginal bleeding with pain
during the third trimester of
 the placenta over the cervix to bleed. The pregnancy. It also can occur
more of the placenta that covers the cervical during labor. However, each
os (the opening of the cervix), the greater the woman may experience
risk for bleeding. symptoms differently. Some
women may not have vaginal
bleeding that is detectable, but
there may be bleeding inside
the uterus.
Presence of painless Abdominal pain and back pain
Pain often begin suddenly.
Uterine Activity   Contractions along with the bleeding.  Uterine tenderness
cramping or tightening that comes or rigidity
with contractions,.
 Uterine
contractions, often
coming one right
after another

Diagnosis An ultrasound examination is used to The symptoms and signs of

establish the diagnosis of placenta previa. placental abruption can mimic
Either a transabdominal (using a probe on the those of other pregnancy
abdominal wall) or transvaginal (with a probe conditions, such as placenta
inserted inside the vagina but away from the previa and pre-eclampsia.
cervical opening) ultrasound evaluation may Information that may be used
be performed, depending upon the location to diagnose placental abruption
of the placenta. Sometimes both types of includes:
ultrasound examination are necessary.  Medical history
 Physical examination,
It is important that the ultrasound
including checking the
examination be performed before a physical
tenderness and tone of
examination of the pelvis in women with
the uterus
suspected placenta previa, since the pelvic
physical examination may lead to further  Internal examination of
bleeding. the vagina and cervix,
using a speculum
 Blood tests
 Ultrasound to check the
placenta
 Fetal heartbeat
monitoring.

Sometimes, the diagnosis of

 placental abruption can’t be
confirmed until childbirth, when
the placenta is delivered with
an attached blood clot that
appears old rather than fresh.
The placenta is usually sent to a
laboratory for further diagnostic
testing.

2. Why is the amount of external bleeding in abruptio placenta not a reliable indicator of the
true amount of blood loss?
 bleeding may occur but the blood may clot between the placenta and the wall of the uterus, so
vaginal bleeding may be scanty or even non-existent. This is known as a ‘retroplacental clot’.