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Placental conditions 

Placental conditions
Chapter:
Placental conditions
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0029
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date: 30 October 2020

This chapter deals with placental conditions including abruption, placenta praevia, morbid adherence (accreta, percreta) and vasa praevia. The aetiology, epidemiology, risk factors, antenatal diagnosis, multidisciplinary management and planning for delivery, recurrence risk in future pregnancy/ies are addressed for each condition. With rising Caesarean section rates, placental pathologies associated with potential maternal mortality/morbidity are increasingly encountered. Abruptio placenta carries a risk of maternal and fetal morbidity/mortality as well as a risk of recurrence. Vasa praevia is increasingly recognized during pregnancy due to better imaging technologies. The important role of postnatal counselling after Caesarean section including contraceptive advice to avoid short interpregnancy intervals is addressed. In suspected morbid adherence of the placenta, imaging with colour flow Doppler and MRI, and the multidisciplinary planning for operative delivery in a suitably equipped unit, are highlighted. Fact files and care pathways for each condition are based on national guidelines and good-practice evidence. Patient information is provided.

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