A Case Report of Successful Management of Central Placenta Previa

Placenta previa is defined as a condition where the placenta is positioned in the lower segment of the uterus, either directly over or very close to the internal cervical os. When the placenta entirely covers the internal os, even after full dilation, it is termed as central or complete placenta previa. This condition occurs in approximately 0.3% of deliveries, with 20% classified as central placenta previa. The present case report discusses a case of central placenta previa with a positive outcome for both the mother and fetus. 

A 33-year-old woman, G2A1, at 33 weeks of gestation presented  with an ultrasound indicating marginal placenta previa. She received regular antenatal care under an expectant management approach. At term, a growth scan revealed complete placenta previa (grade 3) with an amniotic fluid index (AFI) of 13-14 cm and an estimated fetal weight (EFW) of 3020 grams, with a hemoglobin level of 11.5 g/dL.

The patient received steroid treatment at 33 weeks and expectant management continued until 38 weeks, accompanied by regular follow-ups and counselling. An emergency lower segment cesarean section was performed at 38 weeks. Intraoperatively, bleeding was noted at the placental bed, necessitating a transfusion of 1 pint of packed red blood cells postoperatively. Both the mother and baby were reported to be healthy.

To conclude, early detection of placenta previa needs careful monitoring through regular antenatal check-ups and timely delivery to mitigate the associated maternal and perinatal complications. Expectant management during early weeks of pregnancy can enhance outcomes. However, bleeding from the placental site during cesarean delivery for placenta previa can pose significant risks, including postpartum hemorrhage.

Source: Rita D, Archana Reddy. A case of central placenta previa and its successful fetal and maternal outcome. Int J Clin Obstet Gynaecol 2024;8(6):107-109. DOI: 10.33545/gynae.2024.v8.i6b.1548