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Related Experiment Video

Updated: Apr 30, 2026

Ex Vivo Perfusion of the Rodent Placenta
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Published on: May 30, 2019

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Cesarean delivery for placenta previa.

Ottavio Cassardo1, Michele Orsi1, Manuela Wally Ossola1

  • 1Division of Obstetrics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

American Journal of Obstetrics and Gynecology
|January 4, 2026
PubMed
Summary

Placenta previa, a condition requiring cesarean delivery, poses significant risks for mothers and newborns, including hemorrhage and preterm birth. Management balances maternal safety with fetal development, guiding delivery timing and surgical preparedness.

Keywords:
antepartum hemorrhagecesarean deliveryemergent deliverylow-lying placentamaternal morbiditymultidisciplinary managementperinatal mortalityplacenta accreta spectrumplacenta previaplacental abruptionpostpartum hemorrhagepregnancy complicationspreterm birthultrasonographyvasa previa

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Placenta previa affects 0.5%–1% of deliveries, a significant decrease from mid-trimester scans (up to 10%).
  • Risk factors include prior cesarean delivery (4%–8% recurrence), twin gestations, and assisted reproduction (6-fold increased risk).
  • Maternal morbidity is characterized by hemorrhage (40%–60% antepartum, 20%–35% postpartum), and neonatal risk is driven by preterm birth (over 40% before 37 weeks).

Purpose of the Study:

  • To review the diagnosis, management, and outcomes of placenta previa.
  • To highlight the risks associated with placenta previa for both maternal and neonatal health.
  • To provide guidance on antenatal management and delivery planning.

Main Methods:

  • Diagnosis relies on transvaginal ultrasound as the gold standard, confirming transabdominal findings and assessing internal os distance.
  • Management strategies balance the risk of maternal hemorrhage against the risks of iatrogenic prematurity.
  • Delivery planning considers asymptomatic previa (scheduled cesarean at 36–37.6 weeks) and low-lying placenta (trial of labor with internal os distance of 11–20 mm).

Main Results:

  • Placenta previa is a leading indication for preterm delivery before 35 weeks (6%–7%).
  • Multidisciplinary team approach and preparedness for hemorrhage are crucial for operative care.
  • Postpartum support and debriefing are recommended due to the psychological burden.

Conclusions:

  • Effective management of placenta previa requires a multidisciplinary team and careful consideration of delivery timing.
  • Transvaginal ultrasound is essential for accurate diagnosis and exclusion of associated conditions like placenta accreta spectrum and vasa previa.
  • Preparedness for major hemorrhage and structured postpartum support are vital components of care.