gynecology and obstetrics
Placenta Previa
Diagnosis of Placenta Previa
Transvaginal ultrasonography Placenta previa is considered in all women with vaginal bleeding after 20 weeks. If placenta previa is present, pelvic examination, particularly digital cervical examination, may increase bleeding, sometimes causing sudden, massive bleeding; thus, if vaginal bleeding occurs after 20 weeks, pelvic examination is contraindicated unless placenta previa is first ruled out by ultrasonography. Although placenta previa is more likely to cause painless bleeding than Placental Abruption (Abruptio Placentae) , clinical differentiation is still not possible. Thus, ultrasonography is frequently needed to distinguish the two. Transvaginal ultrasonography is an accurate, safe way to diagnose placenta previa. If vaginal bleeding occurs after 20 weeks gestation, exclude placenta previa by ultrasonography before doing a pelvic examination. In all women with suspected symptomatic placenta previa, fetal heart rate monitoring is indicated. 