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Snap Shot
  • A 29-year-old G2P1 female presents to labor and delivery triage with painless bleeding in the third trimester
Introduction
  • Attachment of placenta to lower uterus which occludes internal cervical os
  • Risk factors 
    • multiparity
    • prior C-section
Presentation
  • Symptoms
    • painless bleeding in any trimester
  • Physical exam
    • do NOT perform pelvic exam
Evaluation
  • Ultrasound
    • transabdominal and transvaginal
Treatment
  • Conservative
    • maternal observation
  • Operative
    • Cesarean delivery
 

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