Placenta Previa and Placenta abruption
Nursing Interventions for Placental abruption?
16ga IV, blood ready, VS, Foley for output, H&H and blotting labs
When is Placenta Previa dx?
2nd or 3rd semester trimester
What is placenta abruptio
Detachment of all or part of placenta before birth.
Maternal risks of placental abruption?
High risk for: DIC Hypovolemic shock Renal Failure Infection
Fetal risks of placental abruption?
Hypoxia Preterm Birth IUGR
Special considerations for placenta previa
If preterm and bleeding mildly - may be on activity restriction Ultrasounds to asses Will need delivery by c-section Always have blood typed/crossed and available
How is placenta previa diagnosed?
NO vaginal examination (wil increase chance of separation of increase bleeding) ABD ultrasound to confirm. This to assess placenta and BPP for fetal health
What are S/S of placental abruption?
PAINFUL VAGINAL BLEEDING (PORT WINE colored) HARD BOARD LIKE ABD Internal bleeding (at risks for hypovolemic shock)
Main S/S of placenta previa?
PAINLESS UTERINE BLEEDING
Main differences between Placenta Previa VS abruption?
Placenta Previa is characterized by PAINLESS UTERINE BLEEDING. Abruption is characterized by HARD "BOARDLIKE" ABD.
What is Placenta Previa?
Placenta implanted in lower uterine segment OR Over internal cervical os MOTHER AT RISK FOR HEMORRHAGE
WHat increases chances of placenta abruptio?
Trauma (Battery, MVA), Cocaine use, genetics
Collaborative care for Placental abruption?
hospital tx depends on amount of bleeding and fetal maturity If abruption is minimal and FHR reassuring, vaginal delivery most desirable If FHR no Bueno, C-section needed.