Painless bleeding in 3rd trimester is a feature of
Ans) a (Placenta praevia) Ref Williams 22nd editionCauses of APHa) Placental (70%)- Placenta previa (35%) - Abruption (35%)b) Extra placental (5%)- Cervical carcinoma - Carcinoma cervix - Varicose vein - Local traumac) Unexplained (25%) Stall Worthy sign- Low lying (post type)Dangerous placenta previa - TypeAt 20wks - 30 % placenta low lyingAt term - 2 % placenta low lyingSymptoms- Painless bleeding -Warning haemorrhagesO/E- Malpresentation - Floating head - FHS present - Stall Worthy's signInvestigation-USG - (TVS) - Colour Doppler -MRIClinical complication - Double setup examinationIndication for CS in PP(a) Severe degree of PP (Type IIB & above)(b) Lesser degree where amniotomy fails to stop bleeding(c) Associated factors eg contracted pelvis
Placenta praevia
Abruptio placenta
Vesicular mole
None
Miscellaneous (Gynae)