Placenta Previa

Placenta previa is a condition in which the placenta either partially or totally covers the cervical opening, sometimes referred to as the “cervical os.” It is estimated that placenta previa occurs in approximately 1 in every 200 pregnancies.

A placenta previa is typically characterized as either:

* A complete placenta previa – where the placental tissue completely covers the cervical opening; or
* A partial or marginal placenta previa – where the placenta only partially covers the cervical opening.

Placenta previa is typically diagnosed during the first or second trimester of pregnancy by ultrasound.

For many patients, a partial or marginal placenta previa may resolve by the time the pregnancy enters the third trimester. This phenomenon is known as “placental migration” and simply means the cervical opening or os is no longer covered by the placenta.

In many cases, however, the placenta previa does not resolve, exposing both the mother and the baby to significant risks of death and serious injury related to hemorrhagic placenta previa.

Hemorrhagic placenta previa is typically characterized by painless third trimester bleeding. Often, bleeding will occur with the cervical changes and related uterine contractions which naturally occur as the pregnancy advances through the third trimester.

As a result, when the cervical opening becomes wider and/or uterine activity occurs, the placenta previa can become hemorrhagic, causing both the mother and potentially even the baby to hemorrhage.

Because of this, safe and careful obstetricians will closely monitor any patient diagnosed with complete placenta previa and will typically effect delivery of the baby by cesarean section well prior to the time when any uterine activity or related cervical changes will occur.

Since a complete placenta previa will cover the cervical opening, vaginal delivery can never be safely attempted. Furthermore, patients with complete placenta previa should never have digital pelvic examinations performed since such examinations can themselves result in potentially uncontrollable hemorrhage.

It has long been recognized that placenta previa may cause life-threatening hemorrhage in less than fifteen minutes and that the amount or extent of hemorrhage associated with placenta previa is often unpredictable.

Furthermore, because a baby’s circulating blood volume is so low, fetal hemorrhage associated with placenta previa is particularly dangerous, and may lead to the baby’s death or permanent injury if delivery is not managed in a safe and expeditious fashion.

The Law Firm of Dugan, Babij, Tolley & Kohler, LLC has extensive experience in representing the families whose loved ones have been injured or killed as a result of medical malpractice associated with the management of a patient with placenta previa.

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