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Placenta praevia

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Definition:
Eine Plazenta, die den inneren Muttermund vollständig (Pacenta praevia totalis) oder teilweise bedeckt (Placenta praevia partialis).
Häufigkeit:
Blutungen infolge einer Placenta praevia machen 20 % aller Blutungen in der zweiten Hälfte der Schwangerschaft aus.
Symptome:
Zu den Symptomen zählen Blutungen, die unerwartet und in der Regel ohne Schmerzen und Kontraktionen auftreten.
Befunde:
In der Regel liegen keine klinischen Befunde vor. Vorsichtige gynäkologische Untersuchung mit Spekulumeinstellung durch den Frauenarzt. Ein vaginale Untersuchung ist bei V.a. Placenta praevia obsolet.
Diagnose:
Die Diagnose wird per transvaginalem Ultraschall gestellt.
Behandlung:
Die Patientin ist umgehend einzuweisen. Über eine etwaige Therapie ist individuell zu entscheiden.
  1. Sakornbut E, Leeman L, Fontaine P. Late pregnancy bleeding. Am Fam Physician 2007; 75: 1199-206. American Family Physician  
  2. Bhide A, Prefumo F, Moore J, Hollis B, Thilaganathan B. Placental edge to internal os distance in the late third trimester and mode of delivery in placenta praevia. BJOG 2003; 110: 860-4. PubMed  
  3. Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol 2006; 107: 771-8. pmid:16582111 PubMed  
  4. Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol 2006; 107: 771-8. PubMed  
  5. Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern Fetal Neonatal Med 2003; 13: 175-90. PubMed  
  6. Mustafa SA, Brizot ML, Carvalho MH, Watanabe L, Kahhale S, Zugaib M. Transvaginal ultrasonography in predicting placenta previa at delivery: a longitudinal study. Ultrasound Obstet Gynecol 2002; 20: 356-9. PubMed  
  7. Dashe JS, McIntire DD, Ramus RM, Santos-Ramos R, Twickler DM. Persistence of placenta previa according to gestational age at ultrasound detection. Obstet Gynecol 2002; 99: 692-7. PubMed  
  8. Taipale P, Hiilesmaa V, Ylostalo P. Transvaginal ultrasonography at 18-23 weeks in predicting placenta previa at delivery. Ultrasound Obstet Gynecol 1998; 12: 422-5. PubMed  
  9. Becker RH, Vonk R, Mende BC, Ragosch V, Entezami M. The relevance of placental location at 20-23 gestational weeks for prediction of placenta previa at delivery: evaluation of 8650 cases. Ultrasound Obstet Gynecol 2001; 17: 496-501. PubMed  
  10. Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol 2004; 190: 1135-40. PubMed  
  11. Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 2005; 192: 1458-61. PubMed  
  12. ACOG Committee on Obstetric Practice. Placenta accreta. ACOG Committee opinion No. 266, January 2002. Obstet Gynecol 2002; 99: 169-70. PubMed  
  13. Royal College of Obstetricians and Gynaecologists (RCOG). Placenta praevia and placenta praevia accreta: diagnosis and management. Guideline No. 27. London: RCOG, 2005.
  14. Spong CY, Mercer BM, D'alton M, et al. Timing of indicated late-preterm and early-term birth. Obstet Gynecol 2011; 118:323. PubMed  
  15. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol 2013; 121:908. PubMed  
  16. Neilson JP. Interventions for suspected placenta praevia. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD001998. DOI: 10.1002/14651858.CD001998. DOI  
  17. Wing DA, Paul RH, Millar LK. Management of the symptomatic placenta previa: a randomized, controlled trial of inpatient versus outpatient expectant management. Am J Obstet Gynecol 1996; 175: 806-11. PubMed  
  18. Sharma A, Suri V, Gupta I. Tocolytic therapy in conservative management of symptomatic placenta previa. Int J Gynaecol Obstet 2004; 84: 109-13. PubMed  
  19. National Collaborating Centre for Women's and Children's Health. Antenatal care: routine care for the healthy pregnant woman. Clinical Guideline. London: RCOG, 2003.
  20. Vergani P, Ornaghi S, Pozzi I, et al. Placenta previa: distance to internal os and mode of delivery. Am J Obstet Gynecol 2009; 201: 227-9. PubMed  
  21. Vahanian SA, Lavery JA, Ananth CV et al. Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis. Am J Obstet Gynecol 2015 Oct; 213(4 Suppl): S78-90. pmid:26428506 PubMed  
  22. Cobo E, Conde-Agudelo A, Delgado J, Canaval H, Congote A. Cervical cerclage: an alternative for the management of placenta previa? Am J Obstet Gynecol 1998; 179: 122-5. PubMed  
  • Julia Trifyllis, Dr.med., Fachärztin für Gynäkologie und Geburtshilfe, Münster/W
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL
  • Per Bergsjø, professor emeritus, dr. med., Universitetet i Bergen. Spesialist i kvinnesykdommer og fødselshjelp, forsker ved Nasjonalt folkehelseinstitutt, Oslo
  • Maria Sennström, överläkare, Kvinnokliniken, Karolinska universitetssjukhuset (Medibas)