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OB Theory > Placenta previa, Abruptio placentae > Flashcards

Placenta previa, Abruptio placentae Flashcards

1
Q

placenta is implanted in the lower uterine segment

instead of in the upper posterior

A

Placenta Previa

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2
Q

how much the internal cervical os is covered

A

placenta previa classification

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3
Q

OS is completely covered

-always c-section

A

complete or total

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4
Q

part of os covered

-always c-section

A

partial

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5
Q

edge of placenta close to os

-may be able to deliver

A

marginal

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6
Q

not true placenta previa. Placenta not near os but
implanted in lower uterine segment.
• Usually does not cause complications. May have spotting.

A

low lying placenta previa

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7
Q
  • Advance maternal age (>35 years)
  • Previous cesarean birth
  • Multiparity
  • Short interval between pregnancies
  • Uterine injury
  • History of uterine surgery
A

Risk factors for placenta previa

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8
Q

•Usually diagnoses by ultrasound
•Bright Red, painless bleedingduring 3rd trimester
•1st bleeding episode around 29-30 weeks
-rarely life-threatening
•Increased risk of hemorrhage during labor as cervix dilates and effaces tearing placenta
•Fetus may be in abnormal position

A

Placenta previa S/S

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9
Q
  • Pre-term–bedrest until fetus mature to decrease pressure on placenta and cervix
  • Marginal and low-lying may deliver vaginally unless bleeding is extensive
  • C-section for partial or total to prevent extensive hemorrhage
A

Placenta previa medical management

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10
Q
  • NO vaginal exams (until you know where placenta is at via ultrasound–tears placenta
  • If laboring, monitor blood loss, S/S of hypovolemic shock
  • Monitor VS
  • Monitor FHR–NST, US, biophysical profile
  • Prep for C-section as necessary
  • Emotional support and teaching
A

Placenta previa nursing care

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11
Q

-Monitor postpartum for hemorrhage and infection
-Labs
•CBC
•type and Rh, type and crossmatch
•coagulation profile
•Hgb and Hct

A

Placenta previa nursing care (2)

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12
Q

detachment of part or all of the placenta from its implantation site
•Separation occurs in the decidua basalis after 20 weeks gestation
•Accounts for 15% of perinatal deaths
-50% from prematurity
-intrauterine hypoxia

A

abruption placenta

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13
Q

occurs in center with edges still intact. Usually no visible bleeding.

A

central - abruption placentae

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14
Q

separation along an edge with or without vaginal bleeding

  • detaching from uterine wall, not much blood since it is filling up amneotic sac
  • dark red blood
A

marginal - abruption placentae

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15
Q

total separation. Fetal and maternal compromise. Emergency c-section.

  • no perfusion to baby
  • mom could bleed out
A

complete - abruption placentae

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16
Q
  • Dark Red Bleeding
  • sudden onset of intense, localized uterine pain
  • uterus tender, firmness that becomes rigid
  • crampy contractions that don’t relax - lose resting tones
  • fetal distress may be present due to compromised circulation
A

abruption placentae S/S

17
Q

-Dependent on maternal and fetal status
-C-section if:
•fetal distress
•severe hemorrhage
•poor labor progress
•increasing uterine resting tone
•coagulopathy

A

Abruptio placentae medical management

18
Q 
Vaginal birth if:
•mother’s hemodynamics are stable
•live fetus without distress
•intrauterine death
Fluid replacement with whole blood and LR
•maintain output 30-60ml/hr
•maintain Hct of 30%
A

Abruptio placentae medical management (2)

19
Q
  • Hypertension
  • History of prior abruptio placentae
  • Smoking
  • Cocaine Use
  • Trauma
  • Prior uterine surgery
  • Rupture longer than 24 hours
  • Over distention of the uterus
A

risk factors of abruption placentae

20
Q

-Assess bleeding–amount, color
-Abdominal assessment
•Previa–soft, relaxed, nontender
•Abruptio–tenderness, pain, firm or rigid
-Labs
•CBC
•type and Rh, type and crossmatch
•coagulation profile

A

abruption placentae

21
Q
  • Vital signs, cardiac output monitored
  • FHR monitoring–decelerations, changes in baseline
  • Uterine activity monitored
  • Client and family teaching, emotional support
  • Prep for c-section as necessary
A

aburptio placentae nursing care

OB Theory (16 decks)

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