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  #1  
Old 05-26-2011
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ObGyn Placenta Previa Risk Factors!

A 16-year-old G1P0 girl presents to the emergency department at 32 weeks’ gestation with 2 hours of painless bleeding. She denies any abdominal pain, cramping, or contractions. Her past medical history is significant for two prior episodes of pelvic inflammatory disease. Social history is positive for continued smoking but no alcohol or illicit drug use during the pregnancy. Her temperature is 36.6°C (97.9°F), blood pressure is 111/82 mm Hg, pulse is 76/min, and respiratory rate is 12/min. Fetal heart monitoring shows a fetal heart rate of 158/min with variable accelerations and no decelerations. A diagnosis of placenta previa is confirmed by transabdominal ultrasound. What is the most likely contributing cause to this patient’s condition?

A. Young maternal age
B. Nulliparity
C. Tobacco use
D. Singleton pregnancy
E. Prior history of pelvic inflammatory disease
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Old 05-26-2011
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Definitely not A,B and D. Their opposites are known risk factors. See below!

I would go with C.

Placenta previa is more common among women who:
  • Have already delivered at least one baby
  • Had a previous C-section
  • Had placenta previa with a previous pregnancy
  • Are age 35 or older
  • Are Asian
  • Smoke
  • Are carrying twins, triplets or other multiples
  • Have had a previous uterine surgery, such as myomectomy to remove uterine fibroids or dilation and curettage (D and C) to scrape the uterine lining
  • (http://www.mayoclinic.com/health/pla...N=risk-factors)
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Old 05-26-2011
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I think

E. Prior history of pelvic inflammatory disease

because PID may cause adhesions in uterus .so may affect site of implantation !

am not sure
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Old 05-26-2011
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the correct answer is C. Tobacco use

Placenta Previa Risk Factors!-screen-shot-2011-05-26-9.37.07-pm.png
J Matern Fetal Neonatal Med. 2003 Mar;13(3):175-90.
Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies.
Faiz AS, Ananth CV.
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Old 05-26-2011
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So Tobacco use increases the risk of both placenta accreta and placenta previa?
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Old 05-26-2011
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Definitely the correct answer is C =====>Tobacco use
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