Placenta previa

Question 1

What is placenta previa?

Answer 1

Occurs when the placenta abnormally implants in the lower segment of the uterus near or over the the cervical os instead of attaching to the fundus. this results in bleeding during the third trimester of pregnancy as the cervix begins to dilate and efface.

Question 2

what are the different types of placenta previa?

Answer 2

Complete(total)
Incomplete (partial)
Marginal
Low-lying

Question 3

How is the placenta positioned in a complete or total placenta previa?

Answer 3

The cervical os is completely covered by the placental attachment

Question 4

How is the placenta positioned in an incomplete or partial placenta previa?

Answer 4

The cervical os is only partially covered by the placental attachment

Question 5

How is the placenta positioned in a marginal placenta previa?

Answer 5

The placenta is attached to the lower uterine segment but does not reachh the cervical os

Question 6

How is the placenta positioned in a low-lying placenta previa?

Answer 6

The exact relationship between the placenta and the os has not been determined

Question 7

What are the risk factors for placenta previa?

Answer 7

Previous placenta previa
Uterine scarrin (eg from previous c section)
Maternal age greater than 35 years
Multifetal gestation
Multiple gestations
smoking

Question 8

How does a mother with placenta previa present?

Answer 8

• Painless bright red bleeding during the second or third trimester
• Uterus soft, relaxed and non-tender with normal tone
• Fundal height greater than usually expected for gestational age
• Fetus in breech oblique or transverse position
• Reassuring FHR
• vital signs within normal limits
• Decreasing urinary output which can be a better indication of blood loss

Question 9

Lab tests for Placenta previa

Answer 9

Hgb and Hct for blood loss assessment
CBC
Blood type and RH
coagulation profile
Kleihaur-Betke test (to detect fetal blood in maternal circulation )

Question 10

Diagnostic procedures for placenta previa

Answer 10

• Transabdominal ultrasound for placement for the placenta
• Fetal monitoring for fetal well being assessment

Question 11

Nursing interventions for placenta previa

Answer 11

• Assess for bleeding, leakage, or contractions
• Assess fundal height
• Refrain from performing vaginal exams
• Administer IV fluids, blood products and medications as prescribed
• Administer corticosteriods such as betamethasone to promote fetal lung maturation if indicated
• Have oxygen equipment available foe baby in case of fetal distress

Question 12

Patient education for placenta previa

Answer 12

• Adhere to bed rest
• Do not insert anything in vagina
• which symptoms to contact care provider for