Mother: Geraldine de los Santos 𝑮𝟑 𝑷𝟐 𝑨𝟏 𝑳𝟐

Address: Purok Fatima, Bunao, Dumaguete City

Condition: PLACENTA PREVIA

INTERVIEW QUESTIONS PATIENT’S RESPONSE BOOK/ARTICLE

1. Have you had your Our client stated that sheWomen who suspect they
prenatal visits? had complete prenatal may be pregnant should
- If yes, did you visits. She strictly
schedule a visit to their
strictly follow your followed her schedule. health care provider to
recommended begin prenatal care.
schedule for visits? Prenatal visits to a health
care provider usually
include a physical exam,
weight checks, and
providing a urine sample..
These visits also include
discussions about the
mother's health, the fetus's
health, and any questions
about the pregnancy.
Prenatal care can help
prevent complications
and inform women about
important steps they can
take to protect their infant
and ensure a healthy
pregnancy. (“What is
prenatal” n.d.)
2. Did you take She stated that she took Almost all women need
vitamins/supplements Ferrous Sulfate and Folic some iron
during your Acid during her supplementation during
pregnancy? pregnancy. pregnancy because of a
- If yes, what are variety of factors. The
these? fetus requires a total of
about 350 to 400 mg of
iron to grow. The
increases in the mother’s
circulatory red blood cell
mass require an addi-
tional 400 mg of iron.
(Institute of Medicine (US)
 Committee on Nutritional
Status During Pregnancy
and Lactation.)
3. Did your uterus Our client stated that she Increased parity,
undergo any trauma, has undergone cesarean advanced maternal age,
incision, or injury delivery during her first past cesarean births, past
before? pregnancy. uterine curettage,
- If yes, what was it? multiple gestation, and
perhaps a male fetus are
all associated with
placenta previa. The
incidence is
approximately 5 per 1,000
pregnancies; it is thought
to occur whenever the
placenta is forced to
spread to find an adequate
exchange surface. (Silbert-
Flagg, Pillitteri, 2018)
4. Were you put on any She stated that she was If you aren't bleeding, you
restrictions because of restricted of performing may not need to be in the
your placenta previa? strenuous activities. hospital. But you will
need to be very careful.

Avoid all strenuous

5. Did you know that you She stated that she didn't
had placenta previa? know her placenta was
implanted in the lower
uterine segment until the
last prenatal visit on her
first pregnancy. She also
stated that she was not
expecting she would
activity, such as running
or lifting.
Don't have sex, and don't
put anything in your
vagina.
Call your doctor and go to
the emergency room right
away if you have any
vaginal bleeding.
(“Placenta Previa”, 2018)
Placenta previa, a
condition of pregnancy in
which the placenta is
implanted
abnormally in the lower
part of the uterus, is the
most common cause of
painless bleeding in the
 undergo the same third trimester of
complication on her third pregnancy (Mastrolia,
pregnancy. Baumfeld, Loverro, et al.,
2016)
6. Did you experience The bleeding with
bleeding? placenta previa doesn’t
- How heavy was it? usually begin, however,
Can you estimate until the lower uterine
the amount? segment starts to
- What’s the color? differentiate from the
- Was it upper segment late in
accompanied by pregnancy
pain or (approximately week 30)
contractions? and the cervix begins to
dilate. At that point,
because the placenta is
unable to stretch to
accommodate the
differing shape of the
lower uterine segment or
the cervix, a small portion
loosens and damaged
blood vessels begin to
bleed. The bleeding is
usually abrupt, painless,
bright red, and sudden
enough to frighten a
woman. (Silbert-Flagg,
Pillitteri, 2018)
7. What is the physical Our client stated that her There is a possibility an
condition of your baby did not suffer from increase in congenital fetal
baby? Any congenital any congenital defects anomalies or fetal
defects? Is the baby full and that the baby was also restricted growth could
term? full term. occur if the low
*nay jaundice iyang anak implantation does not
I rephrase nii* allow optimal fetal
nutrition or oxygenation,
but in actual practice, this
rarely happens (Ahmed,
Aitallah, Abdelghafar, et
al., 2015).
8. What is the gender of She told us that the Increased parity,
your baby? gender of her baby is advanced maternal age,
male. past cesarean births, past
uterine curettage,
multiple gestation, and
perhaps a male fetus are
all associated with
placenta previa. The
incidence is
approximately 5 per 1,000
pregnancies; it is thought
to occur whenever the
placenta is forced to
spread to find an adequate
exchange surface. (Silbert-
Flagg, Pillitteri, 2018)
9. When you knew about She stated that she would A vaginal birth is always
having this condition, have wanted a vaginal safest for an infant. It is
were you thinking of delivery but she was still essential, therefore, to
going into CS or an thankful that they were determine the placenta’s
NSVD? What did you both safe despite such location as accurately as
feel when you did not complication. possible in the hope that
end up having the its position will make
preferred delivery? vaginal birth feasible. If
the placenta previa is
found to be total, birth
through the cervix which
is covered by the placenta
is impossible and the baby
must be born by cesarean
birth. (Silbert-Flagg,
Pillitteri, 2018)
10. What was the nature of She told us that she had a If the previa is under 30%
your delivery? cesarean delivery. by abdominal or
intravaginal ultrasound, it
may be possible for the
fetus to be born past it. If
over 30%, and the fetus is
mature, the safest birth
method for both mother
and baby is often a
cesarean birth (Kim,
Joung, Lee, et al., 2015).
11. Did you deliver your She stated that her Your provider will
baby on the expected delivery was scheduled a carefully consider the risk
due date? bit earlier than the of bleeding against early
expected date to avoid delivery of your baby.
bleeding. After 36 weeks, delivery of
the baby may be the best
treatment.

Nearly all women with

placenta previa need a C-
section. If the placenta
covers all or part of the
cervix, a vaginal delivery
can cause severe bleeding.
This can be deadly to both
the mother and baby.
(John D. Jacobson, MD,
Professor of Obstetrics
and Gynecology, Loma
Linda University School
of Medicine, Loma Linda
Center for Fertility, Loma
Linda, CA)
12. Did you experience She shared to us that her Women who use common
abortion in your 2nd pregnancy was a case painkillers like ibuprofen
previous pregnancy? of miscarriage. She didn’t and naproxen early in
know that she was pregnancy may have an
pregnant and suspected increased risk of
that this was because she miscarriage. Researchers
took antipyretics. found that of nearly 52,000
Quebec women who had
been pregnant, those
who'd used a non-
steroidal anti-
inflammatory drug
(NSAID) after conceiving
were more than twice as
likely to suffer a
miscarriage. (“Common
painkillers could”, n.d)
13. What were the She told us that she was Cefuroxime –
medications prescribed with prophylactic
 prescribed to you Cefuroxime and As a second complication,
postpartum? Mefenamic Acid. a woman is more likely to
develop endometritis
because the placental site
is close to the cervix, the
portal of entry for
pathogens. (Silbert-Flagg,
Pillitteri, 2018)
14. How many times did She mentioned that she Increased parity,
you get pregnant? got pregnant three times. advanced maternal age,
past cesarean births, past
uterine curettage,
multiple gestation, and
perhaps a male fetus are
all associated with
placenta previa. (Silbert-
Flagg, Pillitteri, 2018)
15. Did you lose a large She claimed that she lost a The bleeding of placenta
amount of blood after large amount of blood previa, like that of ectopic
the delivery of your and received blood pregnancy, creates an
baby? transfusion. emergency situation as the
- Did you receive open vessels of the uterine
blood transfusion decidua (maternal blood)
during that time? place the mother at risk for
hemorrhage. Any woman
who has had a placenta
previa is more prone than
normal to postpartum
hemorrhage because the
placental site is in the
lower uterine segment,
which does not contract as
efficiently as the upper
segment. Also, because
the uterine blood supply is
less in the lower segment,
the placenta tends to grow
larger than it would
normally, leaving a larger
denuded surface area
when it is removed.
(Silbert-Flagg, Pillitteri,
2018)
 References

Cesarean Delivery. (n.d.). Retrieved from Standforf Children's Health:

https://www.stanfordchildrens.org/en/topic/default?id=cesarean-delivery-92-P07768

Jacobson, J. D. (2018, April 19). Placenta previa. Retrieved from MedlinePlus:

https://medlineplus.gov/ency/article/000900.htm

JoAnne Silbert-Flagg, A. P. (2018). Maternal & child health nursing : care of the childbearing
& childrearing family . Philadelphia: Wolters Kluwer.

Norton, A. (2019, March 07). Common painkillers could cause miscarriages. Retrieved from
Parent24: https://www.parent24.com/Fertility/Miscarriage/Common-
painkillers-could-cause-miscarriages-20110909

Staff, H. (2018, September 5). Placenta Previa. Retrieved from HealthLinkBC:

https://www.healthlinkbc.ca/health-topics/hw180817

What is prenatal care and why is it important? (2017, January 31). Retrieved from Eunice
Kennedy Shiver National Institute of Child Health and Human Development:
https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-
care?fbclid=IwAR0CLMwIxwa3NUNsQIThUIatFpMA2KQquLDYu-
29xPYgExtDMNGBn1DY1WM

COLLEGE OF NURSING
 SILLIMAN UNIVERSITY
DUMAGUETE CITY
NCM 34

AN INTERVIEW AND RESEARCH ON A WOMAN WITH PRENATAL PREGNANCY

COMPLICATIONS

Submitted by:

Ablay, Jeshabelle C.
Delasondra, Lerma Alor D.
Guevarra, Chrisbel P.
Kitane, Angela Claire N.
Labe, Nina Kassandra C.
Manso, Rhaze Marie G.
Pileo, Kristine Jamille R.
Ragas, Tiffany S.
Sederiosa, Irish Mariel V.
Sonjaco, Meilynne Gem C.
Villegas, Sofia Louise A.
SECTION A – A3

Submitted to:

Asst. Prof. Barbara Lyn A. Galvez

NCM 34 Adviser