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NCM 102 RLE 2012.

Placenta Previa

ABRUPTIO PLACENTA
Also termed as accidental hemorrhage and ablatio placenta Premature separation of a normally implanted placenta occurring after the 22nd week of gestation RISK FACTORS Maternal hypertension: PIH, renal disease Sudden uterine decompression as in multiple pregnancy and poluhydramnious Advance age Multiparity Short umbilical cord Trauma; fibrin defects

TYPES Concealed, covert or central bleeding type; Classic Abruptio Placenta Total or partial Placenta separates at the center causing blood to accumulate behind the placenta External blessing not evident Signs of shock not proportional to the amount of external bleeding Placenta separates at the margins Bleeding is external Can be complete or incomplete depending on the degree of detachment Vaginal bleeding is dark red old blood There is severe hemorrhage, internal or external May lead to fetal complications: preterm birth, anemia and respiratory distress syndrome

Marginal, overt or external bleeding type

SIGNS AND SYMPTOMS Painful vaginal bleeding in the third trimester Rigid, boardlike and painful abdomen Enlarged uterus If in labor: tetanic contractions with the absence of alternating contractions and relaxation of the uterus INCIDENCE 2nd leading cause of bleesinng in the 3rd trimester; occurs in 1 in 300 pregnancies.

DIAGNOSIS a. Clinical Diagnosis for the S/S b. Ultrasound to detect the retroplacental bleeding c. Clotting Studies reveals DIH, clortting defects

1|P age

Facilitators: Muralla.Lorca.Tortola.Gito.Ronolo

NCM 102 RLE 2012. Placenta Previa

COMPLICATIONS a. b. c. d. e. f. g. h. hemorrhage shock couelaire uterus DIC CVA Hypofibrinogenemia Renal failure Infection Prematurity, fetal distress/ demise

NURSING MANAGEMENT a. Maintain bedrest, LLR b. Careful monitoring of maternal VS, FHT, labor onset and progress, I&O, uterine pain, sings of bleeding c. Administer IV, plasma or blood as ordered d. Prepare for disgnostic examinations e. Provide psychological support f. Prepare for emergency birth g. Observe for associated problems after delivery: poorly contacting uterus which leads to postpartal hemorrhage; DIH which leads to hemorrhage and possibly CVA; Hypofibrinogenemia which leads to post partal hemorrhage; Prematurity/ neonatal distress which leads to neonata morbidity and mortality

REFERENCE: Rosalinda Salustiano (2009) Essential procedures for safe maternity care

2|P age

Facilitators: Muralla.Lorca.Tortola.Gito.Ronolo

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