PLACENTA PREVIA

PLACENTA PREVIA

Placenta is implanted abnormally in the lower part of the uterus

In placenta previa there is (?) during the (?) trimester

Painless Bleeding; 3rd Trimester

Placenta previa is a condition where the placenta

fully or partially covers the cervix. [causes severe painless bleeding and may cause bleeding throughout pregnancy and delivery] The risk for morbidity and mortality due to blood loss is high making it a serious condition.

3 types of placenta previa:

1. Complete

2. Partial

3. Marginal

Complete

the placenta covers the cervix completely.

Partial

the placenta partly covers the cervix

Marginal

the placenta is 2cm away from the cervix

ANAPHY OF placenta previa

Female Reproductive System:

- Composed of Internal and External organs

Internal Organs

- fallopian tubes, ovaries, cervix, and uterus, which

encapsulate the placenta.

External organs

- all under the vulva including the mons pubis, clitoris, labia minora and majora, vaginal opening, and urethral opening.

placenta

Uterus -

a secondary sexual organ (an organ that matures during puberty influenced by sex hormones) that is responsible for the maintenance and transportation of gametes (eggs for females and sperm for males).

3 parts of the Uterus:

1. Fundus (top)

2. Body (site of implantation)

3. Cervix (links the uterus and vagina)

Fallopian Tube

also known as oviduct, is about 10cm long and consists of three coats: serous, muscular, and mucous. The ova travels through the fallopian tubes to get to the uterus.

Three portions of the fallopian tube:

1. Isthmus

2. Ampulla

3. Infundibulum

Ovaries

an endocrine gland that is about 4cm long and 2cm wide. There are two ligaments that connect it to the body: ovarian (uterus) and suspensory (pelvic wall).

The ovaries produce the hormones?

estrogen and progesterone (sex hormones that contributes to mestruation) and egg cells.

Cervix

a cone-shaped constricted opening that leads to the vagina. It is the passageway for the sperm, childbirth, and menstrual flow.

Placenta

a temporary endocrine gland created during pregnancy that encapsulates the fetus.

Etiology (the word meaning)

the cause or causes of a disease

Etiology of Placenta Previa:

Exact cause is unknown

Common in women:

➢ Advanced maternal age (35 yo and older)

➢ Non-white ethnicity

➢ Previous CS and placenta previa

➢ Multiple pregnancies

➢ Smoking

➢ Cocaine

➢ Uterine problems

Symptomatology (the word meaning)

significant features/manifestations

Symptomatology of Placenta Previa:

❖ Vaginal bleeding (abrupt, bright red, painless and sudden after 7 months or after 28th week gestation; scanty beginning before onset of labor)

❖ Contractions

❖ Unstable Fetal heart rate when maternal shock present

❖ Soft, non-tender uterus

Laboratory and Diagnostic Tests of Placenta Previa:

Ultrasound

Ultrasound:

may be done during prenatal visits or after a vaginal bleeding incident.

A combination of abdominal and transvaginal ultrasound may be needed.

Additional ultrasounds may also be needed to determine the position of the placenta and to see if it has resolved.

Medical Management will depend on

maternal and fetal status, amount of bleeding, gestational age, and fetal and placental position.

Medical Management of placenta previa:

- Rest

- Corticosteroid shots

- Blood Transfusion

Rest

activities that may trigger bleeding should be avoided such as sex and exercise.

Corticosteroid shots

this will help fetal lungs to develop faster.

Blood transfusion

will replace lost blood and prevent hypovolemia.

Pharmacologic Management of placenta previa

May be given corticosteroid shots to help the fetal lungs develop faster.

Surgical Management of placenta previa (if applicable)

Emergency C-section

Emergency C-section

if bleeding persists or if you experience multiple bleeding episodes, you may need an emergency CS, even if the baby is premature.

Infants born prematurely due to placenta previa have a

3-4 times greater rate of morbidity and mortality with an increased risk of low birth weight, low APGAR score, and increased risk for respiratory distress syndrome. However, over 90% of placenta previa cases are resolved through delivery. Prognosis is poor for those with anterior placentas