{"id":918,"date":"2025-06-11T13:18:21","date_gmt":"2025-06-11T10:18:21","guid":{"rendered":"https:\/\/wiki.voka.io\/diseases\/uncategorized\/predlezhanie-placenty\/"},"modified":"2026-06-23T12:04:15","modified_gmt":"2026-06-23T09:04:15","slug":"placenta-previa","status":"publish","type":"diseases_post","link":"https:\/\/wiki.voka.io\/pt\/doencas\/obstetricas\/placenta-previa\/","title":{"rendered":"Placenta pr\u00e9via: Classifica\u00e7\u00e3o, diagn\u00f3stico, riscos e gest\u00e3o da gravidez"},"content":{"rendered":"<p><?xml encoding=\"UTF-8\" ?><\/p>\n<p class=\"wp-block-paragraph\">A placenta pr\u00e9via (<em>placenta previa<\/em>) \u00e9 uma condi\u00e7\u00e3o quando a placenta apresenta uma inser\u00e7\u00e3o baixa, na parte inferior do \u00fatero com o suprimento sangu\u00edneo insuficiente, obstruindo assim a abertura interna do colo. Esta condi\u00e7\u00e3o desenvolve-se em 0,3% a 2% das gesta\u00e7\u00f5es no terceiro trimestre. Em gravidezes mais precoces, uma condi\u00e7\u00e3o semelhante \u00e9 definida como c\u00f3rion previa, a membrana externa do feto a partir da qual a placenta se forma mais tarde (at\u00e9 \u00e0s 16 semanas), mas esta condi\u00e7\u00e3o n\u00e3o \u00e9 uma patologia no in\u00edcio da gravidez.<\/p>\n<h2 class=\"wp-block-heading\" id=\"etiologia\"><strong>Etiologia <\/strong><\/h2>\n<p class=\"wp-block-paragraph\">A causa fundamental do desenvolvimento da placenta pr\u00e9via ainda n\u00e3o foi estabelecida. No entanto, existe uma rela\u00e7\u00e3o entre a forma\u00e7\u00e3o da placenta pr\u00e9via e a les\u00e3o do endom\u00e9trio causada por v\u00e1rios fatores etiol\u00f3gicos. <\/p>\n<p class=\"wp-block-paragraph\">Por isso, foram identificados os seguintes <strong>fatores de risco<\/strong>, que aumentam a probabilidade de desenvolvimento de placenta pr\u00e9via:<\/p>\n<ul class=\"wp-block-list\">\n<li>A idade da m\u00e3e \u00e9 superior a 35 anos;<\/li>\n<li>Nascimentos m\u00faltiplos;<\/li>\n<li>Hist\u00f3ria de interrup\u00e7\u00e3o da gravidez;<\/li>\n<li>Interven\u00e7\u00f5es cir\u00fargicas na cavidade uterina (curetagem, etc.);<\/li>\n<li>Leiomioma uterino de grandes dimens\u00f5es;<\/li>\n<li>Utiliza\u00e7\u00e3o de tecnologias de fertiliza\u00e7\u00e3o in vitro;<\/li>\n<li>Hist\u00f3ria de cirurgia uterina;<\/li>\n<li><em>Hist\u00f3rico de placenta pr\u00e9via<\/em> na gravidez anterior;<\/li>\n<li>Fumar;<\/li>\n<li>Ra\u00e7a (\u00e9 um fator de risco controverso, alguns estudos mostram que o risco \u00e9 maior nas mulheres asi\u00e1ticas e africanas).<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A implanta\u00e7\u00e3o requer um ambiente com um fornecimento adequado de sangue. As c\u00e9lulas trofobl\u00e1sticas da camada externa do blastocisto desenvolvem-se na placenta e nas membranas fetais. O trofoblasto se fixa \u00e0 membrana decidual do \u00fatero. O efeito das patologias que constituem fatores de risco tem um impacto negativo na forma\u00e7\u00e3o dos vasos placent\u00e1rios, o que perturba o fluxo sangu\u00edneo placent\u00e1rio e leva ao desenvolvimento de anomalias na placenta\u00e7\u00e3o. <\/p>\n<h2 class=\"wp-block-heading\" id=\"classificacao-da-placenta-previa\"><strong>Classifica\u00e7\u00e3o da placenta pr\u00e9via<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">De acordo com a classifica\u00e7\u00e3o, a placenta pr\u00e9via \u00e9 diagnosticada quando a borda placent\u00e1ria est\u00e1 a menos de 20 mm do orif\u00edcio cervical interno do colo uterino. A placenta pr\u00e9via divide-se em central (ou total), com obstru\u00e7\u00e3o total do canal cervical e lateral (ou parcial), neste caso, o canal cervical fica obstru\u00eddo apenas em dois ter\u00e7os <a href=\"https:\/\/catalog.voka.io\/en\/models\/5d5e2bef-26af-4dc6-88b4-205ca36c1d80\/c1487f46-dc74-4de7-b3d2-b9ddee2fa713\/e7fcbf7c-42ed-4dc0-8c68-e2a3036c5422\/7759d1ce-5155-4720-97c2-adc503806ba8\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Modelo 3D<\/a>:<\/p>\n<div class=\"carousel-block\">\n<div class=\"swiper carousel-swiper carousel-swiper-block_6a734c41de988\">\n<div class=\"swiper-wrapper\">\n<div class=\"swiper-slide image-carousel-slide\"><img decoding=\"async\" class=\"carousel-image\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/ru\/akusherstvo\/predlezhanie-placenty\/polnoe-centralnoe-predlezhanie-placenty-vid-sboku-a-vid-sniezu-b.webp\" alt=\"Placenta pr\u00e9via total (central): vista lateral (esquerda), vista de baixo (direita)\"><span class=\"small-text-article text-main-text-color\">Placenta pr\u00e9via total (central): vista lateral (esquerda), vista de baixo (direita)<\/span><\/div>\n<div class=\"swiper-slide image-carousel-slide\"><img decoding=\"async\" class=\"carousel-image\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/ru\/akusherstvo\/predlezhanie-placenty\/placenta%20previa_central.webp\" alt=\"Placenta pr\u00e9via parcial (lateral)\"><span class=\"small-text-article text-main-text-color\">Placenta pr\u00e9via parcial (lateral)<\/span><\/div>\n<\/div>\n<\/div>\n<div class=\"swiper-article-carousel__controls\">\n<div class=\"swiper-article-carousel__pagination-container swiper-article-carousel__pagination-container-block_6a734c41de988\"><\/div>\n<div class=\"swiper-article-carousel__arrows\"><button class=\"swiper__arrow swiper__arrow--prev carousel-swiper-button-prev swiper__arrow swiper__arrow--prev carousel-swiper-button-prev-block_6a734c41de988\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"40\" viewbox=\"0 0 40 40\" fill=\"none\"><path d=\"M20 3.75C16.7861 3.75 13.6443 4.70305 10.972 6.48862C8.29969 8.27419 6.21689 10.8121 4.98696 13.7814C3.75704 16.7507 3.43524 20.018 4.06225 23.1702C4.68926 26.3224 6.23692 29.2179 8.50952 31.4905C10.7821 33.7631 13.6776 35.3107 16.8298 35.9378C19.982 36.5648 23.2493 36.243 26.2186 35.013C29.1879 33.7831 31.7258 31.7003 33.5114 29.028C35.297 26.3557 36.25 23.2139 36.25 20C36.2455 15.6916 34.5319 11.561 31.4855 8.51454C28.439 5.46806 24.3084 3.75455 20 3.75ZM23.3844 25.3656C23.5005 25.4818 23.5926 25.6196 23.6555 25.7714C23.7184 25.9231 23.7507 26.0858 23.7507 26.25C23.7507 26.4142 23.7184 26.5769 23.6555 26.7286C23.5926 26.8804 23.5005 27.0182 23.3844 27.1344C23.2682 27.2505 23.1304 27.3426 22.9786 27.4055C22.8269 27.4683 22.6643 27.5007 22.5 27.5007C22.3358 27.5007 22.1731 27.4683 22.0214 27.4055C21.8696 27.3426 21.7318 27.2505 21.6156 27.1344L15.3656 20.8844C15.2494 20.7683 15.1572 20.6304 15.0943 20.4787C15.0314 20.3269 14.999 20.1643 14.999 20C14.999 19.8357 15.0314 19.6731 15.0943 19.5213C15.1572 19.3696 15.2494 19.2317 15.3656 19.1156L21.6156 12.8656C21.7318 12.7495 21.8696 12.6574 22.0214 12.5945C22.1731 12.5317 22.3358 12.4993 22.5 12.4993C22.6643 12.4993 22.8269 12.5317 22.9786 12.5945C23.1304 12.6574 23.2682 12.7495 23.3844 12.8656C23.5005 12.9818 23.5926 13.1196 23.6555 13.2714C23.7184 13.4231 23.7507 13.5858 23.7507 13.75C23.7507 13.9142 23.7184 14.0769 23.6555 14.2286C23.5926 14.3804 23.5005 14.5182 23.3844 14.6344L18.0172 20L23.3844 25.3656Z\" fill=\"#B5C0CD\"><\/path><\/svg><\/button><button class=\"swiper__arrow swiper__arrow--next carousel-swiper-button-next swiper__arrow swiper__arrow--next carousel-swiper-button-next-block_6a734c41de988\" tabindex=\"0\" aria-label=\"Next slide\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"40\" viewbox=\"0 0 40 40\" fill=\"none\"><path d=\"M20 3.75C16.7861 3.75 13.6443 4.70305 10.972 6.48862C8.29969 8.27419 6.21689 10.8121 4.98696 13.7814C3.75704 16.7507 3.43524 20.018 4.06225 23.1702C4.68926 26.3224 6.23692 29.2179 8.50952 31.4905C10.7821 33.7631 13.6776 35.3107 16.8298 35.9378C19.982 36.5648 23.2493 36.243 26.2186 35.013C29.1879 33.7831 31.7258 31.7003 33.5114 29.028C35.297 26.3557 36.25 23.2139 36.25 20C36.2455 15.6916 34.5319 11.561 31.4855 8.51454C28.439 5.46806 24.3084 3.75455 20 3.75ZM23.3844 25.3656C23.5005 25.4818 23.5926 25.6196 23.6555 25.7714C23.7184 25.9231 23.7507 26.0858 23.7507 26.25C23.7507 26.4142 23.7184 26.5769 23.6555 26.7286C23.5926 26.8804 23.5005 27.0182 23.3844 27.1344C23.2682 27.2505 23.1304 27.3426 22.9786 27.4055C22.8269 27.4683 22.6643 27.5007 22.5 27.5007C22.3358 27.5007 22.1731 27.4683 22.0214 27.4055C21.8696 27.3426 21.7318 27.2505 21.6156 27.1344L15.3656 20.8844C15.2494 20.7683 15.1572 20.6304 15.0943 20.4787C15.0314 20.3269 14.999 20.1643 14.999 20C14.999 19.8357 15.0314 19.6731 15.0943 19.5213C15.1572 19.3696 15.2494 19.2317 15.3656 19.1156L21.6156 12.8656C21.7318 12.7495 21.8696 12.6574 22.0214 12.5945C22.1731 12.5317 22.3358 12.4993 22.5 12.4993C22.6643 12.4993 22.8269 12.5317 22.9786 12.5945C23.1304 12.6574 23.2682 12.7495 23.3844 12.8656C23.5005 12.9818 23.5926 13.1196 23.6555 13.2714C23.7184 13.4231 23.7507 13.5858 23.7507 13.75C23.7507 13.9142 23.7184 14.0769 23.6555 14.2286C23.5926 14.3804 23.5005 14.5182 23.3844 14.6344L18.0172 20L23.3844 25.3656Z\" fill=\"#B5C0CD\"><\/path><\/svg><\/button><\/div>\n<\/div>\n<\/div>\n<p><script defer>\n    document.addEventListener('DOMContentLoaded', function() {\n        const imagesCarouselSwiper = new Swiper('.carousel-swiper-block_6a734c41de988', {\n            slidesPerView: 1,\n            spaceBetween: 20,\n            loop: true,\n            pagination: {\n                el: '.swiper-article-carousel__pagination-container-block_6a734c41de988',\n                clickable: true,\n            },\n            navigation: {\n                nextEl: '.carousel-swiper-button-next-block_6a734c41de988',\n                prevEl: '.carousel-swiper-button-prev-block_6a734c41de988',\n            },\n        })\n    })\n<\/script><\/p>\n<p class=\"wp-block-paragraph\">Existe tamb\u00e9m uma condi\u00e7\u00e3o denominada placenta baixa. Neste caso, o bordo da placenta situa-se entre 20 e 35 mm.<\/p>\n<h3 class=\"wp-block-heading\" id=\"tipos-de-placenta-previa\">Tipos de placenta pr\u00e9via<\/h3>\n<figure class=\"wp-block-table table-to-cards table-accents\">\n<table>\n<thead>\n<tr>\n<th class=\"has-text-align-center\" data-align=\"center\">Tipo de localiza\u00e7\u00e3o da placenta<\/th>\n<th class=\"has-text-align-center\" data-align=\"center\">Dist\u00e2ncia entre a borda placent\u00e1ria e a abertura cervical<\/th>\n<th class=\"has-text-align-center\" data-align=\"center\">Grau de obstru\u00e7\u00e3o do canal cervical<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td class=\"has-text-align-center\" data-align=\"center\">Placenta baixa<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\">20-35 mm<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\">N\u00e3o cobre a abertura interna<\/td>\n<\/tr>\n<tr>\n<td class=\"has-text-align-center\" data-align=\"center\">Placenta pr\u00e9via<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\"><20 mm<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\">Obstru\u00e7\u00e3o total ou parcial do orif\u00edcio interno do colo do \u00fatero<\/td>\n<\/tr>\n<tr>\n<td class=\"has-text-align-center\" data-align=\"center\">Placenta pr\u00e9via parcial (lateral)<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\"><20 mm<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\">Cobre cerca de 2\/3 do canal cervical<\/td>\n<\/tr>\n<tr>\n<td class=\"has-text-align-center\" data-align=\"center\">Placenta pr\u00e9via total (central)<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\"><20 mm<\/td>\n<td class=\"has-text-align-center\" data-align=\"center\">Obstru\u00e7\u00e3o total do orif\u00edcio interno do colo do \u00fatero<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n<div class=\"videos-carousel-block\">\n<div class=\"swiper video-carousel-swiper video-carousel-swiper-block_6a734c4213bf5\">\n<div class=\"swiper-wrapper\">\n<div class=\"swiper-slide\"><video controls class=\"carousel-video\"><source data-src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/en\/%20%20obstetrics\/placenta-previa\/central-placental-presentation.webm\" type=\"video\/webm\"><\/source><\/video><span class=\"small-text-article text-main-text-color\">Anima\u00e7\u00e3o 3D \u2013 placenta pr\u00e9via total (central)<\/span><\/div>\n<div class=\"swiper-slide\"><video controls class=\"carousel-video\"><source data-src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/en\/%20%20obstetrics\/placenta-previa\/lateral-placental-presentation.webm\" type=\"video\/webm\"><\/source><\/video><span class=\"small-text-article text-main-text-color\">Anima\u00e7\u00e3o 3D \u2013 Placenta pr\u00e9via lateral<\/span><\/div>\n<\/div>\n<\/div>\n<div class=\"swiper-article-video-carousel__controls\">\n<div class=\"swiper-article-video-carousel__pagination-container swiper-article-video-carousel__pagination-container-block_6a734c4213bf5\"><\/div>\n<div class=\"swiper-article-video-carousel__arrows\"><button class=\"swiper__arrow swiper__arrow--prev video-carousel-swiper-button-prev swiper__arrow swiper__arrow--prev video-carousel-swiper-button-prev-block_6a734c4213bf5\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"40\" viewbox=\"0 0 40 40\" fill=\"none\"><path d=\"M20 3.75C16.7861 3.75 13.6443 4.70305 10.972 6.48862C8.29969 8.27419 6.21689 10.8121 4.98696 13.7814C3.75704 16.7507 3.43524 20.018 4.06225 23.1702C4.68926 26.3224 6.23692 29.2179 8.50952 31.4905C10.7821 33.7631 13.6776 35.3107 16.8298 35.9378C19.982 36.5648 23.2493 36.243 26.2186 35.013C29.1879 33.7831 31.7258 31.7003 33.5114 29.028C35.297 26.3557 36.25 23.2139 36.25 20C36.2455 15.6916 34.5319 11.561 31.4855 8.51454C28.439 5.46806 24.3084 3.75455 20 3.75ZM23.3844 25.3656C23.5005 25.4818 23.5926 25.6196 23.6555 25.7714C23.7184 25.9231 23.7507 26.0858 23.7507 26.25C23.7507 26.4142 23.7184 26.5769 23.6555 26.7286C23.5926 26.8804 23.5005 27.0182 23.3844 27.1344C23.2682 27.2505 23.1304 27.3426 22.9786 27.4055C22.8269 27.4683 22.6643 27.5007 22.5 27.5007C22.3358 27.5007 22.1731 27.4683 22.0214 27.4055C21.8696 27.3426 21.7318 27.2505 21.6156 27.1344L15.3656 20.8844C15.2494 20.7683 15.1572 20.6304 15.0943 20.4787C15.0314 20.3269 14.999 20.1643 14.999 20C14.999 19.8357 15.0314 19.6731 15.0943 19.5213C15.1572 19.3696 15.2494 19.2317 15.3656 19.1156L21.6156 12.8656C21.7318 12.7495 21.8696 12.6574 22.0214 12.5945C22.1731 12.5317 22.3358 12.4993 22.5 12.4993C22.6643 12.4993 22.8269 12.5317 22.9786 12.5945C23.1304 12.6574 23.2682 12.7495 23.3844 12.8656C23.5005 12.9818 23.5926 13.1196 23.6555 13.2714C23.7184 13.4231 23.7507 13.5858 23.7507 13.75C23.7507 13.9142 23.7184 14.0769 23.6555 14.2286C23.5926 14.3804 23.5005 14.5182 23.3844 14.6344L18.0172 20L23.3844 25.3656Z\" fill=\"#B5C0CD\"><\/path><\/svg><\/button><button class=\"swiper__arrow swiper__arrow--next video-carousel-swiper-button-next swiper__arrow swiper__arrow--next video-carousel-swiper-button-next-block_6a734c4213bf5\" tabindex=\"0\" aria-label=\"Next slide\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"40\" height=\"40\" viewbox=\"0 0 40 40\" fill=\"none\"><path d=\"M20 3.75C16.7861 3.75 13.6443 4.70305 10.972 6.48862C8.29969 8.27419 6.21689 10.8121 4.98696 13.7814C3.75704 16.7507 3.43524 20.018 4.06225 23.1702C4.68926 26.3224 6.23692 29.2179 8.50952 31.4905C10.7821 33.7631 13.6776 35.3107 16.8298 35.9378C19.982 36.5648 23.2493 36.243 26.2186 35.013C29.1879 33.7831 31.7258 31.7003 33.5114 29.028C35.297 26.3557 36.25 23.2139 36.25 20C36.2455 15.6916 34.5319 11.561 31.4855 8.51454C28.439 5.46806 24.3084 3.75455 20 3.75ZM23.3844 25.3656C23.5005 25.4818 23.5926 25.6196 23.6555 25.7714C23.7184 25.9231 23.7507 26.0858 23.7507 26.25C23.7507 26.4142 23.7184 26.5769 23.6555 26.7286C23.5926 26.8804 23.5005 27.0182 23.3844 27.1344C23.2682 27.2505 23.1304 27.3426 22.9786 27.4055C22.8269 27.4683 22.6643 27.5007 22.5 27.5007C22.3358 27.5007 22.1731 27.4683 22.0214 27.4055C21.8696 27.3426 21.7318 27.2505 21.6156 27.1344L15.3656 20.8844C15.2494 20.7683 15.1572 20.6304 15.0943 20.4787C15.0314 20.3269 14.999 20.1643 14.999 20C14.999 19.8357 15.0314 19.6731 15.0943 19.5213C15.1572 19.3696 15.2494 19.2317 15.3656 19.1156L21.6156 12.8656C21.7318 12.7495 21.8696 12.6574 22.0214 12.5945C22.1731 12.5317 22.3358 12.4993 22.5 12.4993C22.6643 12.4993 22.8269 12.5317 22.9786 12.5945C23.1304 12.6574 23.2682 12.7495 23.3844 12.8656C23.5005 12.9818 23.5926 13.1196 23.6555 13.2714C23.7184 13.4231 23.7507 13.5858 23.7507 13.75C23.7507 13.9142 23.7184 14.0769 23.6555 14.2286C23.5926 14.3804 23.5005 14.5182 23.3844 14.6344L18.0172 20L23.3844 25.3656Z\" fill=\"#B5C0CD\"><\/path><\/svg><\/button><\/div>\n<\/div>\n<\/div>\n<p><script defer>\n    document.addEventListener('DOMContentLoaded', function() {\n        const videosCarouselSwiper = new Swiper('.video-carousel-swiper-block_6a734c4213bf5', {\n            slidesPerView: 1,\n            spaceBetween: 20,\n            loop: true,\n            pagination: {\n                el: '.swiper-article-video-carousel__pagination-container-block_6a734c4213bf5',\n                clickable: true,\n            },\n            navigation: {\n                nextEl: '.video-carousel-swiper-button-next-block_6a734c4213bf5',\n                prevEl: '.video-carousel-swiper-button-prev-block_6a734c4213bf5',\n            },\n            on: {\n                slideChangeTransitionStart: function () {\n                    const videos = this.el.querySelectorAll('video');\n                    videos.forEach(video => {\n                        if (!video.paused) {\n                            video.pause();\n                            video.currentTime = 0;\n                        }\n                    });\n                },\n            }\n        })\n    })\n<\/script><\/p>\n<h2 class=\"wp-block-heading\" id=\"sintoma-de-placenta-previa\"><strong>Sintoma de placenta pr\u00e9via<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">O sangramento vaginal indolor em qualquer fase da gravidez \u00e9 um sintoma t\u00edpico de placenta pr\u00e9via. Al\u00e9m disso, o sangramento indolor pode ocorrer ap\u00f3s a rela\u00e7\u00e3o sexual, exame vaginal e, \u00e0s vezes, sem causa aparente. <\/p>\n<h2 class=\"wp-block-heading\" id=\"diagnostico-da-placenta-previa\"><strong>Diagn\u00f3stico da placenta pr\u00e9via<\/strong><\/h2>\n<ul class=\"wp-block-list\">\n<li><strong>Durante o exame especular<\/strong>, \u00e9 poss\u00edvel visualizar a placenta, no caso de dilata\u00e7\u00e3o do colo do \u00fatero. Cabe ressaltar que o exame vaginal e o exame com esp\u00e9culos s\u00e3o realizados apenas em ambiente cir\u00fargico. <\/li>\n<li><strong>A ecografia<\/strong> durante o rastreio pr\u00e9-natal permite identificar oportunamente a placenta pr\u00e9via. Deve ser efectuada n\u00e3o s\u00f3 a ecografia transabdominal, mas tamb\u00e9m a transvaginal. A ecografia transvaginal tem-se revelado segura e mais exacta para o diagn\u00f3stico da placenta pr\u00e9via. O diagn\u00f3stico \u00e9 feito entre a 28\u00aa e a 32\u00aa semana de gravidez. A dist\u00e2ncia entre a borda da placenta e o canal cervical deve ser medida com muita precis\u00e3o. No entanto, \u00e9 recomend\u00e1vel ter cuidado ao realizar uma ecografia transvaginal, dado que isso pode causar sangramento. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">Al\u00e9m disso, importa mencionar que a maioria das placentas diagnosticadas com localiza\u00e7\u00e3o baixa no in\u00edcio da gravidez j\u00e1 n\u00e3o s\u00e3o visualizadas no final da gesta\u00e7\u00e3o. A placenta em si n\u00e3o se move, mas cresce em dire\u00e7\u00e3o ao aumento do fornecimento de sangue no fundo uterino. A mudan\u00e7a na localiza\u00e7\u00e3o da placenta \u00e9 o resultado da forma\u00e7\u00e3o do segmento inferior do \u00fatero em crescimento. O trofoblasto liga-se \u00e0 membrana decidual do \u00fatero. <\/p>\n<p class=\"wp-block-paragraph\">A placenta\u00e7\u00e3o anormal no segmento uterino inferior pouco vascularizado provoca crescimento placent\u00e1rio compensat\u00f3rio e aumento da \u00e1rea de superf\u00edcie em resposta \u00e0 diminui\u00e7\u00e3o da perfus\u00e3o placent\u00e1ria, causando altera\u00e7\u00f5es histopatol\u00f3gicas correspondentes sob a forma de necrose coagulativa das vilosidades cori\u00f3nicas e deposi\u00e7\u00e3o de fibrina no espa\u00e7o interviloso. As altera\u00e7\u00f5es morfol\u00f3gicas que ocorrem na placenta pr\u00e9via podem desempenhar um papel importante na manuten\u00e7\u00e3o de uma perfus\u00e3o adequada, o que pode evitar resultados neonatais adversos.<\/p>\n<p class=\"wp-block-paragraph\"><strong>O diagn\u00f3stico diferencial<\/strong> \u00e9 geralmente realizado em casos de sangramento vaginal em qualquer fase da gravidez. No 1\u00ba e 2\u00ba trimestres esta complica\u00e7\u00e3o pode causar:<\/p>\n<ul class=\"wp-block-list\">\n<li>Hematoma subcori\u00f3nico;<\/li>\n<li>Amea\u00e7a de aborto;<\/li>\n<li>Gravidez ect\u00f3pica;<\/li>\n<li>Cancro do colo do \u00fatero. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">No terceiro trimestre, o sangramento vaginal \u00e9 geralmente causado por risco de parto prematuro, mas, em 1% dos casos, por descolamento prematuro da placenta normalmente inserida e, raramente, por vasa pr\u00e9via. <\/p>\n<p class=\"wp-block-paragraph\">Vale ressaltar que mulheres com placenta pr\u00e9via e placenta baixa apresentam um risco elevado de parto prematuro ao longo de toda a gravidez. As gr\u00e1vidas com placenta pr\u00e9via apresentam um risco maior de parto prematuro em compara\u00e7\u00e3o com as mulheres com placenta baixa. <\/p>\n<p class=\"wp-block-paragraph\">O uso de progesterona, a coloca\u00e7\u00e3o de pess\u00e1rio vaginal e\/ou a cerclagem podem ser interven\u00e7\u00f5es preventivas potencialmente eficazes, mas n\u00e3o h\u00e1 dados sistem\u00e1ticos sobre a seguran\u00e7a e a efic\u00e1cia desses m\u00e9todos. <\/p>\n<p class=\"wp-block-paragraph\">O descolamento prematuro da placenta normalmente inserida tamb\u00e9m se manifesta por sangramento vaginal, mas acompanhado de dor intensa. <\/p>\n<p class=\"wp-block-paragraph\">A vasa pr\u00e9via \u00e9 uma condi\u00e7\u00e3o quando os vasos sangu\u00edneos do feto atravessam as membranas amni\u00f3ticas desprotegidos. Ocorre em 1 em cada 5.000 gesta\u00e7\u00f5es. A integridade dos vasos pode ser comprometida em caso de ruptura das membranas, seja de origem espont\u00e2nea ou induzida. <\/p>\n<h2 class=\"wp-block-heading\" id=\"complicacao-da-placenta-previa\"><strong>Complica\u00e7\u00e3o da placenta pr\u00e9via<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">A placenta acreta \u00e9 uma complica\u00e7\u00e3o da placenta pr\u00e9via, e essa condi\u00e7\u00e3o deve ser descartada durante a ecografia. Esta condi\u00e7\u00e3o requer, na maioria dos casos, uma histerectomia devido a uma hemorragia maci\u00e7a, mas a preserva\u00e7\u00e3o do \u00fatero \u00e9 poss\u00edvel com uma cirurgia de rotina de alta tecnologia ou pode ser aplicada uma t\u00e9cnica de separa\u00e7\u00e3o tardia da placenta at\u00e9 que o leito placent\u00e1rio se desvascularize, de modo a que o tecido placent\u00e1rio remanescente possa ser removido com maior seguran\u00e7a. Em caso de suspeita de placenta acreta, \u00e9 necess\u00e1rio realizar uma resson\u00e2ncia magn\u00e9tica. <\/p>\n<p class=\"wp-block-paragraph\">Os m\u00e9todos de diagn\u00f3stico de valor hist\u00f3rico incluem a imagem com radiois\u00f3topos e a arteriografia. <\/p>\n<h2 class=\"wp-block-heading\" id=\"tratamento\"><strong>Tratamento<\/strong><\/h2>\n<ul class=\"wp-block-list\">\n<li><strong>A terapia tocol\u00edtica<\/strong> pode ser utilizada em casos de sangramento leve com menos de 36 semanas de gesta\u00e7\u00e3o; al\u00e9m disso, s\u00e3o utilizados neuroprotetores e f\u00e1rmacos para prevenir a s\u00edndrome da ang\u00fastia respirat\u00f3ria do rec\u00e9m-nascido. <\/li>\n<li><strong>Terapia hemost\u00e1tica<\/strong>: hemost\u00e1ticos, hemoderivados e substitutos do plasma, bem como inibidores da fibrin\u00f3lise, s\u00e3o utilizados com o objetivo de estancar o sangramento.<\/li>\n<li><strong>Medidas de repouso<\/strong>: recomenda-se \u00e0 paciente manter repouso absoluto, reduzir a atividade f\u00edsica e evitar rela\u00e7\u00f5es sexuais.<\/li>\n<li><strong>O tratamento da anemia <\/strong>: em casos de sangramentos recorrentes, existe o risco de desenvolvimento de anemia, o que tamb\u00e9m requer tratamento medicamentoso com suplementos de ferro. <\/li>\n<li><strong>Prontid\u00e3o para transfus\u00e3o<\/strong>: quando uma paciente com esse diagn\u00f3stico est\u00e1 internada, \u00e9 necess\u00e1rio ter o sangue do grupo correspondente e seus componentes dispon\u00edveis para acesso imediato, se necess\u00e1rio.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\" id=\"parto-particularidades-da-cirurgia-de-cesariana\"><strong>Parto: particularidades da cirurgia de cesariana<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">O principal m\u00e9todo de parto continua sendo a cesariana programada, por volta de 37 semanas de gesta\u00e7\u00e3o. No entanto, algumas pacientes podem apresentar complica\u00e7\u00f5es que exigem uma cesariana de emerg\u00eancia em uma idade gestacional mais precoce. Normalmente, esta situa\u00e7\u00e3o \u00e9 causada por uma hemorragia maci\u00e7a de mais de 250 ml. <\/p>\n<p class=\"wp-block-paragraph\">Durante uma cesariana, recomenda-se uma incis\u00e3o vertical na pele para um acesso ideal. Nos casos em que a placenta est\u00e1 implantada no segmento inferior do \u00fatero, ou se esse segmento n\u00e3o estiver suficientemente formado, \u00e9 necess\u00e1ria uma incis\u00e3o vertical no \u00fatero. Ap\u00f3s o nascimento do feto, a placenta deve ser separada espontaneamente; \u00e9 proibida a separa\u00e7\u00e3o manual da placenta. As mulheres devem ser informadas sobre uma poss\u00edvel emboliza\u00e7\u00e3o da art\u00e9ria uterina ou histerectomia. Recomenda-se uma analgesia neuroaxonal e a anestesia geral \u00e9 utilizada apenas em casos de emerg\u00eancia.<\/p>\n<h2 class=\"wp-block-heading\" id=\"parto-vaginal\"><strong>Parto vaginal<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">As doentes a quem foi diagnosticada uma placenta baixa podem ter direito a um parto fisiol\u00f3gico se a gravidez for prematura e se a amniotomia for efectuada precocemente, mas t\u00eam um risco acrescido de hemorragia p\u00f3s-parto e podem tamb\u00e9m ter de ser operadas. \u00c9 de salientar que n\u00e3o existem dados sobre os benef\u00edcios do metotrexato.<\/p>\n<h2 class=\"wp-block-heading\" id=\"prognostico-para-o-feto\"><strong>Progn\u00f3stico para o feto<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">A taxa de mortalidade e morbidade neonatal associada \u00e0 placenta pr\u00e9via aumentou de 3 a 4 vezes, o que, em geral, est\u00e1 relacionado ao parto prematuro. <\/p>\n<div class=\"social-banner-block\">\n<div class=\"social-banner-content\">\n<p class=\"h5-title text-black\">Encontra mais conte\u00fados cientificamente exactos nas nossas redes sociais<\/p>\n<p><span class=\"social-banner-text text-grey\">Subscreve e n\u00e3o percas os recursos mais recentes<\/span><\/p>\n<div class=\"banner-icons-wrapper\"><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.facebook.com\/VOKA3DAnatomyAndPathology\/\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/facebook.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.instagram.com\/voka.io\/\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/insta.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.linkedin.com\/company\/voka-io\/posts\/?feedView=all\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/linkedin.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.youtube.com\/@vokaio\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/youtube.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.pinterest.com\/voka3danatomyandpathology\/\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/pinterest.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/www.tiktok.com\/@voka.io\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/tiktok.svg\" alt=\"social link\"><\/a><a class=\"social-icon-link\" href=\"\" data-link=\"https:\/\/discord.gg\/7ejUpq8DRR\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/Social%20Icons\/discord.svg\" alt=\"social link\"><\/a><\/div>\n<\/div>\n<p><img decoding=\"async\" class=\"social-banner-image\" loading=\"lazy\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/common\/social-media-banner-mobile-image.webp\" alt=\"Banner background\"><\/div>\n<h2 class=\"wp-block-heading\" id=\"prognostico-para-a-mae\"><strong>Progn\u00f3stico para a m\u00e3e<\/strong><\/h2>\n<p class=\"wp-block-paragraph\">Se a placenta estiver localizada na parede anterior do \u00fatero, existe uma maior probabilidade de perda maci\u00e7a de sangue, o que aumenta os riscos da histerectomia. Este grupo de mulheres apresenta maior risco de desenvolver complica\u00e7\u00f5es como: <\/p>\n<ul class=\"wp-block-list\">\n<li>Transfus\u00e3o de sangue;<\/li>\n<li>Danos em \u00f3rg\u00e3os adjacentes;<\/li>\n<li>Septicemia;<\/li>\n<li>Realiza\u00e7\u00e3o de manobras de reanima\u00e7\u00e3o;<\/li>\n<li>Desenvolvimento de placenta pr\u00e9via na gravidez seguinte;<\/li>\n<li>Morre.<\/li>\n<\/ul>\n<div>\n<h2 class=\"faq-title h2-article\" id=\"faq\">FAQ<\/h2>\n<div class=\"faq-section\">\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">1. Quais s\u00e3o as manifesta\u00e7\u00f5es cl\u00ednicas da placenta pr\u00e9via?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">O principal sintoma cl\u00ednico da placenta pr\u00e9via \u00e9 o sangramento vaginal indolor, que pode ocorrer repentinamente em qualquer fase da gravidez. O sangramento geralmente ocorre ap\u00f3s a rela\u00e7\u00e3o sexual ou ap\u00f3s o exame ginecol\u00f3gico, mas \u00e0s vezes surge sem motivo aparente. No caso de placenta pr\u00e9via total, o sangramento costuma ser mais intenso e come\u00e7a mais cedo do que na placenta pr\u00e9via parcial.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">2. Quando \u00e9 diagnosticada a placenta pr\u00e9via total?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">A placenta pr\u00e9via total \u00e9 diagnosticada no exame de ultrassom, quando a placenta cobre completamente o colo do \u00fatero. O diagn\u00f3stico definitivo \u00e9 estabelecido ap\u00f3s 28 semanas de gesta\u00e7\u00e3o, uma vez que a migra\u00e7\u00e3o placent\u00e1ria \u00e9 poss\u00edvel antes desse per\u00edodo. A ecografia transvaginal \u00e9 o m\u00e9todo de diagn\u00f3stico mais preciso.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">3. O que se deve evitar nos casos de placenta pr\u00e9via?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">As restri\u00e7\u00f5es para placenta pr\u00e9via incluem: proibi\u00e7\u00e3o absoluta de rela\u00e7\u00f5es sexuais, exclus\u00e3o de qualquer atividade f\u00edsica (incluindo levantar e carregar mais de 3 kg) e recusa de exames vaginais fora da sala de cirurgia. As pacientes devem evitar viagens longas e viagens a\u00e9reas devido ao risco de provocar sangramento. Deve-se dar especial aten\u00e7\u00e3o ao equil\u00edbrio psicoemocional, uma vez que situa\u00e7\u00f5es estressantes podem desencadear complica\u00e7\u00f5es hemorr\u00e1gicas. Qualquer sangramento vaginal requer atendimento m\u00e9dico imediato.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">4. Qual \u00e9 o perigo da placenta pr\u00e9via marginal?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">A placenta pr\u00e9via marginal apresenta o risco de sangramento s\u00fabito, que pode levar \u00e0 anemia e ao parto prematuro. Embora nessa condi\u00e7\u00e3o a placenta cubra apenas parcialmente o colo do \u00fatero, permanece a possibilidade de uma cesariana de emerg\u00eancia caso o sangramento se torne amea\u00e7ador.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">5. Quais s\u00e3o as recomenda\u00e7\u00f5es cl\u00ednicas para a placenta pr\u00e9via?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">As recomenda\u00e7\u00f5es cl\u00ednicas para a placenta pr\u00e9via incluem cesariana programada \u00e0s 36-37 semanas em caso de placenta pr\u00e9via total, interna\u00e7\u00e3o hospitalar obrigat\u00f3ria em caso de sangramento e monitoramento ultrassonogr\u00e1fico regular. Em caso de sangramento leve no in\u00edcio da gravidez, pode-se optar por uma estrat\u00e9gia de observa\u00e7\u00e3o e espera, mantendo repouso absoluto.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"sources-list-block sources-list-hidden\" id=\"referencias\">\n<div class=\"sources-list-content\">\n<div class=\"sources-list-title\">\n<p class=\"small-text-bold text-black sources-list-title-text\">Refer\u00eancias<\/p>\n<div class=\"sources-expand-button-wrapper-mobile\">\n<div class=\"sources-expand-button\"><svg width=\"32\" height=\"32\" viewbox=\"0 0 32 32\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M8 12L16 20L24 12\" stroke=\"#8C9AAB\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\n<\/div>\n<\/div>\n<div class=\"sources-list-items\">\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">1.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>VOKA 3D Anatomy & Pathology \u2013 Complete Anatomy and Pathology 3D Atlas (VOKA 3D Anatomia e Patologia \u2013 Atlas 3D completo de anatomia e patologia) [Internet]. VOKA 3D Anatomy & Pathology [VOKA 3D Anatomia & Patologia]. <\/cite><\/p>\n<p><span class=\"small-text-medium text-grey\">Dispon\u00edvel em: https:\/\/catalog.voka.io\/<\/span><\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">2.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Ahn KH, Lee EH, Cho GJ, Hong SC, Oh MJ, Kim HJ. A placenta pr\u00e9via anterior no segundo trimestre da gravidez como fator de risco de s\u00edndrome da ang\u00fastia respirat\u00f3ria do rec\u00e9m-nascido. PLoS One. 2018;13(11):e0207061.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">3.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Ryu JM, Choi YS, Bae JY. Controle hemorr\u00e1gico por meio de sutura cont\u00ednua intrauterina durante a cesariana em gestantes com placenta pr\u00e9via. Arch Gynecol Obstet. 2019 Jan;299(1):135-139.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">4.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Silver RM, Branch DW. Espectro da placenta acreta. N Engl J Med. 19 de abril de 2018; 378(16):1529-1536.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">5.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Jing L, Wei G, Mengfan S, Yanyan H. Efeito da localiza\u00e7\u00e3o da placenta nos resultados da gravidez em pacientes com placenta pr\u00e9via. PLoS One. 2018;13(7):e0200252.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">6.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Carusi DA. O espectro da placenta acreta: epidemiologia e fatores de risco. Clin Obstet Gynecol. 2018 Dec;61(4):733-742.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">7.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Parecer n.\u00ba 764 do Comit\u00ea da ACOG: Parto pr\u00e9-termo tardio e parto a termo precoce por indica\u00e7\u00e3o m\u00e9dica. Obstetr\u00edcia e Ginecologia. Fevereiro de 2019; 133(2):e151-e155. <\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">8.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Wing DA, Paul RH, Millar LK. Tratamento da placenta pr\u00e9via sintom\u00e1tica: um estudo randomizado e controlado comparando o tratamento expectante em regime de internamento ou em ambulat\u00f3rio. Am J Obstet Gynecol. Outubro de 1996; 175(4, Parte 1):806-11.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">9.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Riveros-Perez E, Wood C. An\u00e1lise retrospectiva do manejo obst\u00e9trico e anest\u00e9sico de pacientes com dist\u00farbios do espectro da placenta acreta. Int J Gynaecol Obstet. 2018 Mar;140(3):370-374. <\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">10.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Jansen C, de Mooij YM, Blomaard CM, Derks JB, van Leeuwen E, Limpens J, Schuit E, Mol BW, Pajkrt E. Parto vaginal em mulheres com placenta baixa: uma revis\u00e3o sistem\u00e1tica e meta-an\u00e1lise. BJOG. 2019 Ago;126(9):1118-1126.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">11.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Col\u00e9gio Americano de Obstetras e Ginecologistas; Sociedade de Medicina Materno-Fetal. Consenso sobre cuidados obst\u00e9tricos n.\u00ba 7: Espectro da placenta acreta. Obstetr\u00edcia e Ginecologia. Dezembro de 2018; 132(6):e259-e275.<\/cite><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"sources-expand-button-wrapper\">\n<div class=\"sources-expand-button\"><svg width=\"32\" height=\"32\" viewbox=\"0 0 32 32\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M8 12L16 20L24 12\" stroke=\"#8C9AAB\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>A placenta pr\u00e9via (placenta previa) \u00e9 uma condi\u00e7\u00e3o quando a placenta apresenta uma inser\u00e7\u00e3o baixa, na parte inferior do \u00fatero com o suprimento sangu\u00edneo insuficiente, obstruindo assim a abertura interna do colo. Esta condi\u00e7\u00e3o desenvolve-se em 0,3% a 2% das gesta\u00e7\u00f5es no terceiro trimestre. Em gravidezes mais precoces, uma condi\u00e7\u00e3o semelhante \u00e9 definida como c\u00f3rion [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"template":"","diseases_category":[299],"class_list":["post-918","diseases_post","type-diseases_post","status-publish","hentry","diseases_category-obstetricas"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.0 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Placenta pr\u00e9via: classifica\u00e7\u00e3o, causas, sintomas, tratamento<\/title>\n<meta name=\"description\" content=\"Placenta pr\u00e9via na gravidez: etiologia, quadro cl\u00ednico, tipos, riscos, complica\u00e7\u00f5es e abordagens atuais para o manejo. 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