CaseCase A 32 years old woman,now pregnancyfor 33 weeks.Last night during sleepingshe suffered from severe painless vaginalbleeding without any cause ,and the blee-ding stopped spontaneously 15 minuteslater.Now the patient’s Bp is 90/60mmHg,P is 98 bpm.

QuestionsQuestions

• What is the possible disease the patient suffered from?

• What accessory examination should be done?

• How to manage the patient and what is the treating principle for this disease?

Key wordsKey words

placenta previa 前置胎盘fetal presentation 胎先露

Trophoblastic Trophoblastic 滋养叶的滋养叶的succenturiate placenta succenturiate placenta 副胎盘副胎盘Engagement Engagement 衔接衔接placental murmur placental murmur 胎盘血管鸣胎盘血管鸣Postpartum 产后Anticipating therapy 期待疗法cesarean section 剖宫产vaginal delivery 阴式分娩Placenta abruption 胎盘早剥

Placenta previaPlacenta previa

前置胎盘前置胎盘

Contents of the lecture

• Definition

• Etiology

★ Classification

★ Clinical manifestation

• Diagnosis

★ Management

Definition If the placenta is

attached to the low segment of uterus,its low edge reaches or covers the internal OS of cervix and is below the fetal presentation,it is called placenta previa.

Etiology

. Ⅰ Trophoblastic development

retardation

. Over large placentaⅡ

. Ⅲ Endometrial lesion and damage

. Abnormal placenta:such asⅣ succenturiate placenta

1

2

6

※Classification• complete placenta previa • partial placenta previa • marginal placenta previa

Complete placenta previa

Partial placenta previa

Marginal placenta previa

※Clinical manifestation

• Symptoms

• signs

Symptoms

vaginal bleeding:vaginal bleeding:

PainlessPainlessrecurrent recurrent without any causewithout any cause

signs• General conditionGeneral condition : :Anemia Anemia

shock shock

• Abdominal examinationAbdominal examination : :

uterine size

engagement of fetal presentation

placental murmurplacental murmur

uterine size

engagement of fetal presentation

Diagnosis

• Symptoms• Body signs• Vaginal examination• Ultrasound examination• Postpartum examination of

placenta and fetal membrane

Vaginal examination

Ultrasound examination

rupture

Management

• Anticipating therapy

• Termination of pregnancy

1.the indication of the termination of

pregnancy

2.cesarean section

3.vaginal delivery

cesarean section

vaginal delivery

• Definition

• Etiology

★ Classification

★ Clinical manifestation

• Diagnosis

★ Management

Summary of the lecture

Next lecture…Next lecture…

• Differentiation diagnosis

• Placenta abruption

CaseCase A 32 years old woman,now pregnancyfor 33 weeks.Last night during sleepingshe suffered from severe painless vaginalbleeding without any cause ,and the blee-ding stopped spontaneously 15 minuteslater.Now the patient’s Bp is 90/60mmHg,P is 98 bpm.

QuestionsQuestions

• What is the possible disease the patient suffered from?

• How to manage the patient and what is the treating principle for this disease?

• How to manage the patient and what is the treating principle for this disease?