理解的对吗？谢谢

前置胎盘

WORKUP

• Do not perform a digital vaginal examination.

• Perform a speculum examination in a hospital setting to exclude any local bleeding. 

• Perform a transvaginal ultrasonography to assess for placental location.

• Exclude the presence of placenta previa-accreta in patients with a history of cesarean sections. In a prospective study, the frequency of placenta accreta increased with an increasing number of cesarean deliveries: 3% for first cesarean, 11% for second cesarean, 40% for third cesarean, 61% for fourth cesarean, and up to 67% for fifth or more cesarean sections. 

LABORATORY TESTS 

• A complete blood count can be used to monitor hemoglobin and hematocrit. 

• A Kleihauer-Betke preparation of maternal blood in all Rh-negative women and Rh-immune globulin when indicated

检查

l 不要徒手进行阴道检查。

l 在医院内行内窥镜检查，以排除任何部位的局部出血。

l 行经阴道超声检查以评估胎盘位置。

l 在有剖宫产史的患者中排除前置植入性胎盘。在一项前瞻性研究中，植入胎盘的频率随着剖宫产次数的增加而增加：第一次剖腹产为3%，第二次剖腹产为11%，第三次剖腹产为40%，第四次剖腹产为61%，大于等于五次剖腹产的比例高达67%。

实验室检查

l 可以用全血计数检查来监测血红蛋白和红细胞压积。

l 所有Rh阴性孕妇准备做Kleihauer-Betke检查，如果有适应症注射Rh免疫球蛋白

理解的对吗？谢谢