Which of the following statements concerning placenta pre is TRUE?
The initial hemorrhage in placenta pre is usually painless and rarely fatal. If the fetus is premature and if hemorrhaging is not severe, vaginal examination of a woman suspected of having placenta pre frequently can be delayed until 37 weeks gestation; this delay in the potentially hazardous examination reduces the risk of prematurity, which is often associated with placenta pre. Vaginal examination, when needed to determine whether a low- lying placenta is covering the internal os of the cervix, should be performed in an operating room fully prepared for an emergency cesarean section. Increasing maternal age and multiparity are associated with a higher incidence of placenta pre. Also Know: Placenta pre is used to describe a placenta that is implanted over or very near the internal cervical os. There are several possibilities: Total placenta pre--the internal os is covered completely by placenta Paial placenta pre--the internal os is paially covered by placenta Marginal placenta pre--the edge of the placenta is at the margin of the internal os Low-lying placenta--the placenta is implanted in the lower uterine segment such that the placental edge does not reach the internal os, but is in close proximity to it Vasa pre--the fetal vessels course through membranes and present at the cervical os. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 35. Obstetrical Hemorrhage. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
Its incidence decreases with maternal age
Its incidence is unaffected by parity
The initial hemorrhage is usually painless and fatal
Vaginal examination should be done immediately on suspicion of placenta pre