Title PLACENTA PREVIJA - PROBLEM SUVREMENE OPSTETRICIJE
Title (english) PLACENTA PREVIA - THE PROBLEM OF MODERN OBSTETRICS
Author Lucija Beram
Mentor Oleg Petrović (mentor)
Committee member Aleks Finderle (predsjednik povjerenstva)
Committee member Ozren Mamula (član povjerenstva)
Committee member Vedran Frančišković (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Gynaecology and Obstetrics) Rijeka
Defense date and country 2018-09-21, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Placenta previja se pojavljuje u približno 0,4% trudnoća. Definirana je implantacijom posteljice u donjem uterinom segmentu, tako da djelomično ili potpuno prekriva unutarnje ušće. Dijagnoza se obično postavlja u drugoj polovici trudnoće pomoću transvaginalne sonografije. Terminologija je, međutim, još uvijek nedosljedna. Klasifikacija s obzirom na sonografske kriterije razlikuje placentu previju, koja prekriva unutarnje ušće u bilo kojoj mjeri, i nisko sijelo placente, gdje placentni rub ne pokriva unutarnje ušće, već je unutar 2 centimetra od ušća. Stanje je često komplicirano invazijom korionskih resica dublje od decidue basalis uzrokujući placenta accreta sindrom. Zbog svog položaja u donjem uterinom segmentu koji ima povećanu vaskularnost i smanjenu kontraktilnost, najčešće se pojavljuje karakteristično vaginalno krvarenje, osobito u trećem tromjesečju trudnoće i s početkom poroda. Povećana je učestalost placente previje kod žena s prethodnim carskim rezom ili drugim operacijama na maternici, uznapredovalom dobi majke, multiparitetom i pušenjem. Planirani carski rez kod žena sa stabilnom placentom previjom se radi u 36. i 37. tjednu trudnoće, iako uslijed epizoda ponavljanih krvarenja veći broj žena treba carski rez ranije. Nakon poroda izgledno je teško krvarenja iz mjesta implantacije, čije suzbijanje predstavlja veliki izazov kliničarima. Majčine komplikacije uključuju masivno krvarenje (prepartalno, intrapartalno i postpartalno), placentu accreta-u i histerektomiju. Neonatalne komplikacije povezane s placentom previjom uključuju prematuritet, kongenitalne anomalije, sindrom respiratornog distresa i anemiju. Multidisciplinarni pristup je najbolji način za smanjenje morbiditeta i mortaliteta.
Abstract (english) Placenta previa occurs in approximately 0.4% pregnancies. It is defined by implantation of placenta in the lower uterine segment so that it partially or completely covers the internal os. It is usually diagnosed in the second half of pregnancy using vaginal sonography. Terminology is, however, still inconsistent. Classification, when taking into consideration sonography criterium, differentiates between placenta previa, where internal os is covered to any degree, and low-lying placenta, where the edge of placenta doesn’t cover internal os but is within 2 centimetres of it. Placenta previa could lead to further complications due to invasion of placental villi deep from basal plate causing placenta accrete syndrome. Position of placenta in the lower uterine segment, which has increased vascularity and low contractility, in most cases leads to characteristic vaginal bleeding, particularly in the third trimester of the pregnancy and the beginning of the labour. The women with the increased risk of recurring placenta previa are those who have previously undergone Caesarean section or other uterine surgeries, are of advanced age as well as multiparity and smoking. In women with stable placenta previa, an elective Caesarean section is usually accomplished at 36 or 37 weeks of pregnancy. However, due to repeated bleeding episodes, Caesarean often needs to be carried out earlier in the pregnancy. After delivery, severe bleeding from the implantation site is expected. Its suppression is a major challenge for clinicians. Maternal complications include massive bleeding (antepartum, intrapartum and postpartum), placenta accreta and hysterectomy. Neonatal complications associated with previa include preterm birth, congenital anomalies, respiratory distress syndrome and anemia. Multidisciplinary approach is the best way to reduce morbidity and mortality.
Keywords
placenta previja
carski rez
vaginalno krvarenje
Keywords (english)
Placenta Previa
Cesarean Section
Language croatian
URN:NBN urn:nbn:hr:184:239799
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2018-11-16 14:11:54