H-MOLE -scar

Monitor hcg - displace the placenta

-elevated amount of hcg What to assess

Normal 4000 -bleeding (remember bright red bleeding)

Every 6 months of -painless

Observe bleeding – dark brown -uterus, nontender, soft

Client needs blood transfusion Presenting part is placenta- no engagement

Usually occupy the lower segment

H- usually happen ?? -placenta has a role to

Placenta happens in 3rd trimester -less blood, less nutrients

Placenta privia- problem implantation Complication

abnormally in the uterus.
Leads to endometrities –
Normal site of placenta at the upper segment of
Hemorrhage- placenta not contract effectively
the uterus
Congenital fetal anomaly
Types of placenta previa

Complete, partial,
Management
Complete previa- tries to cover totally the
cervical opening -dr. advise client for bed rest in side lying
position w/in 22 hours
The placenta covers a portion of the cervical
opening - know the duration, when bleeding started,
amount of
Marginal- placenta is approaching the cervical
opening No pelvic exam, rectal exam

Low lying- lower sement of the uterus -monitor v/s, hemoglobin, hematocrit, platelet
count,
-related to advance maternal age
Determine the location of the placenta. (usually
-past cesaarial activity
lower segment of the placenta)
-surgery
Less than 30 pecent the client deliver via nsd
-multiple ges.
Over 30 percent- baby somewhat mature – CS
-having male baby delivery

Double set up –

Presence oft Beta – 24 weeks via IM 12-12.5 – 12-24 hours

Avoid quitus -sharp stabbing pain at the upper seg. Of the
uterus
p- position
-uterine tenderness
painless
-heavy bleeding
r- refrain from EI and rectal exam
-concealed/hidden bleeding – color of the blood
relax, soft and non tender
is dark red accumulates in the uterus
e-ncourage bed rest
-uterus is rigid
oxygen via face mask
-uterus is somewhat hard – abprution
v-vital/s monitoring hemorrhage

fetal hr – normal check fetal movement

visible bleeding -client risk of vesinianted con

i- iv fluid, needle guage should be 18, for prep -we need to know the grade of placental
of bloof trnas ceparation

a-bnormal fetal position Grade 1- minimal ceparation of the placenta, no

bleeding, not affect babay’s v/s, not affect
mother and baby
ABRAPTIO PLACENTA 2-
-premature separation of a normal placenta 3- extreme sep, mother experience shock
-happens during third trimerster, early increase v/s,
separation -circualtion is not good
When will this placenta separate- after the -profuse bleeding of the uterus cause
delivery of the baby suffocation of the baby

Management
Factors - Need to good iv fluid
-hyparity - Monitor fht (irreg, or absent)
- Maternal v/s 5-15 mins
-advance maternal age - No abdominal exam, no rectal exam
-tube short umbilical cor - Terminate preg grade 2-3
- Historectomy
-vaso constrition- placenta ceparate- use of
cocaine A- premature sep., painful, dark red bleeding

-direct trauma of the belly , uterus tender

V- fiv

r- refrain from rectal exam

utilize oxygen

t- o monitor total heart tone

o bserve s/s of hypovolemic shock

aside from dessiminated

dark red

t- tender uterus uppen palpation

c- concealed bleeding unsean bleeding

h- haed uterus , cobeal

d- istress to the baby

comparission

abprup concealed

prlacenr

soft and relax

placenta previa

-delayed- depending to the size of the fetus and

the amount of bleeding

dark red

abruption

-immediate delivery (cs

-light red

QUIZ- pregestational to the last topic less than

50