• Gestational Diabetes
• Preeclampsia
• Preterm Labor
• Post-term Pregnancy
• Intrauterine Growth Restriction (IUGR)
• Polyhydramnios
• Oligohydramnios
• Placenta abruption and previa
• Twin-to-Twin Transfusion Syndrome (TTTS)

10 things to know about Placental Abruption and Previa

1. Placental abruption is the premature separation of the placenta from the uterine wall before delivery.
2. Placental abruption occurs in 1% of pregnancies. There is a 10% risk of abruption occurring again in future pregnancy.
3. Placental abruption is suspected with contractions, vaginal bleeding, and sudden, continuous abdominal pain. Sonogram helps to confirm the diagnosis. The cause for placental abruption is unknown.
4. Risk for placental abruption include:
• Trauma
• Rapid decompression of the uterus after ruptured membrane in polyhydramnios or delivery of the first twin
• Chronic disease such as diabetes, hypertention, preecclampsia
• Previous history of placental abruption
• Preterm Premature rupture of membranes
• Cocaine abuse
• Smoking
5. Mild partial abruption is small and self limited separation of the placenta
   • Can cause irritation of uterus or labor
   • Partial abruption may precede massive abruption
   • The baby may be able to tolerate well and thus may allow conservative management or vaginal delivery

   Severe total abruption is complete separation of the placenta

   • Can cause preterm labor or stillbirth
   • Can be life threatening to mother and baby
   • Massive blood loss can cause DIC (disseminated intravascular coagulation) which cause bleeding in other area due to inability of blood to clot
   • The baby may not able to tolerate labor and -an emergency cesarean section may be necessary.

   Placenta previa is low lying placenta that covers part or all of the opening of the cervix. Most placenta previa are discovered on routine ultrasound. In 90% of the cases, the placenta, slightly over or close to the cervix, will move away before the due date.

6. Placenta previa occurs in 1/200 pregnancies at term.
7. The cause for placenta previa is unknown.
8. Risk for placenta previa include
• Prior cesarean section
• Prior uterine surgeries including dilation and curettage
• Placenta previa in previous pregnancy
• Twins, triple etc
• Cocaine abuse
• Smoking
9. Placenta previa can present as painless vaginal bleeding during the second half of pregnancies. Bleeding may be massive and may threaten the lives of mother and baby. Most women with placenta previa do not have bleeding.
10. Placenta previa may require hospital stay until delivery. If the bleeding stops, a woman with complete previa may be monitored closely until cesarean section about 36 weeks. If the bleeding does not stop, or if she is in labor, a cesarean section is recommended