Placenta Previa

Jeannet E. Canda, RN
NDDU
College of Nursing
Definition
This is where a placenta is inserted
partially or wholly in the lower
uterine segment.



pictures
placenta Previa
placenta Previa
Etiology
Endometrium disorder and injury
Massive placenta
Abnormal placenta
Germ cell with delay of trophblast
developing
Classification
Complete placenta previa
Partial placenta previa
Marginal placenta previa
Clinical presentation
Manifestation
It characteristically presents with
unprovoked and repeated painless
vaginal bleeding.

Manifestation
The classification of previa placenta
sometimes determines the occurrence
period and the volume of losing blood.
symptom
Severe blood losing leads to several
shock signs ,such as paleness ,weak and
quick pulse and hypotension.

Malpresentation maybe exists,and
floating presentation could be found
during late gestational weeks.
Diagnosis
History
Symptom
Vaginal examination
Ultrasonography
Placenta and membrane examination
after delivery

Risk
Postpartum haemorrhage
Implanted placenta
Postpartum infection
Amnion fluid embolism
Premature delivery and increasing
perinatal mortality


Treatment
Expectant delivery

aim at achieving amixmum fetal
maturity possible while minimizing
the risk to both mother and fetus.


Expectant delivery

The method apply to the patient
with small and self-limited
bleeding ,and without fatal risk either
to fetus or mother.

Immediate delivery
Indications:

When the bleeding is profuse and life is
threatening , no matter the fetus is
mature or unmature ,alive or dead.

If bleeding continues but is neither
profuse nor life threatening and the
gestation is more than 34 weeks.



Method

cesarean section
Transvaginal delivery
Emergency managment