PATHOPHYSIOLOGY

Increase progesterone and estrogen level

Pre – embryonic stage

Production of fertilized ovum

Implantation in the uterus

Embryonic stage
PRECIPITATING FACTORS
• Smoking
• Cocaine use
PREDISPOSING FACTORS Placenta arise from the trophoblast tissue • Curettage
• Succenturiate and bilobate
• Advanced maternal age (Age
placenta
greater than 35 years old)
• Multiparity • History of Cesarean sections
• Twins or multiple pregnancy (CS)
• Prior placenta previa
 Scarring of uterine tissue Abnormal vascularization of endometrium Larger placenta

Deep attachment of the placenta Insufficient blood supply Increased covered surface area

Placenta migrates to where there is sufficient

blood supply

Placenta resides in the lower segment

Complete/Total Partial Placenta Marginal Placenta Low lying Placenta

Placenta previa previa previa previa
the placenta completely the placenta partially covers the placenta is near the the placenta encroaches the lower
covers the top of the cervix the top of the cervix edge of the cervix segment of the uterus but does not
infringe on the cervical os.

• Diagnosed early in pregnancy on routine abdominal ultrasound at 18 to 20 weeks

• Transvaginal sonogram

Cervical dilatation Cover internal os of cervix Disrupted placental attachment Uterine contraction
 SURGICAL Abnormal fetal position Decreased uterine blood
MANAGEMENT: flow
Cesarean section

Painless bright red Decreased fetal oxygen

SURGICAL
vaginal bleeding supply
MANAGEMENT:
DIAGNOSTIC TEST:
Emergency Cesarean
Transabdominal
section
sonogram
Blood loss Fetal distress

Intrauterine
Decreased blood growth
volume restriction
SURGICAL (IUGR)
MANAGEMENT
Hysterectomy Hypovolemia Preterm labor

Congenital anomalies
Pallor Decreased kidney Hypotension Decreased capillary
perfusion refill time

Tachypnea
Cold clammy skin Decreased urine Compensatory
output mechanism

Tachycardia
 If treated If not treated
Decrease venous return

Decrease preload
MANAGEMENT Profuse bleeding
Decrease cardiac output
• Bed rest
• Avoidance of sexual POOR PROGNOSIS Hypotension
intercourse
• Follow-up check ups
• C-SECTION Perfusion failure and
HYPOVOLEMIC
• Blood transfusion tissue hypoxia
SCHOCK

Organ Dysfunction
COMA
GOOD PROGNOSIS Multiple organ failure

DEATH OF MOTHER
AND FETUS
 LEGEND
PATHOPHYSIOLOGY DIAGNOSTIC TEST

MEDICAL/SURGICAL
MECHANISM
MANAGEMENT

PREDISPOSING GOOD PROOGNOSIS

FACTORS

PRECIPITATING COMPLICATIONS
FACTORS /POOR PROGNOSIS

TYPES OF PLACENTA
PREVIA DEATH

DEFINITION

SIGNS AND
SYMPTOMS

SURGICAL
MANAGEMENT