12/5/2023 0 Comments Partial bed rest![]() ![]() If the placenta is not delivered promptly after detachment, the body can experience DIC.The patient can enter shock without seeing the amount of blood loss.Įxperiences DIC ( disseminated intravascular coagulation): a super event of clotting in the body followed by a depletion of clotting factors that leads to uncontrolled bleeding and possibly death. PROM (premature rupture of the membranes)Įxtended fundal height from concealed bleedingĬoncealed bleeding that can stay inside the uterus and back flow into the fallopian tubes.What can cause premature detachment of the placenta? Types of abruptio placentae include partial or total detachment. The placenta is usually delivered within 10-20 minutes after the delivery of the baby….learn more about the stages of labor. It detaches itself after the birth of the baby because it is no longer needed. When should the placenta normally detach from the uterine wall? In some cases women with a marginal previa (low lying) may be allowed to have baby vaginally.Ĭomplication: Issues with placenta separating completely from uterus because it has embedded deep within the uterus…condition called placenta accreta ….major risk of hemorrhage…may need hysterectomy.Ī DETACHMENT ISSUE!! There is detachment of the placenta from the uterine wall BEFORE the birth of the baby. If bleeding can’t be stopped will need c-section.Ĭontractions causing bleed: may be ordered to give tocolytics (drugs to stop contractions)Īmniocentesis to assess lung maturity of baby and steroids may be given to help baby’s lung mature.Ĭ-section is usually ordered for a partial or complete previa.monitoring amounts of blood loss (are a lot of pads and linens soiled with blood?), place mom on left side lying position (increases the amount of blood and nutrients going to the baby via the placenta).external monitor to monitor baby’s heart tones, monitoring mom’s vital signs per protocol every 15 minutes (low blood pressure and increased HR….shock).may need blood transfusion (type and cross match, RH negative….need RhoGAM, IV access (pick 18 gauge or bigger) for transfusion of blood products and fluids, monitoring CBC, clotting levels.If woman is experiencing bleeding: hospitalized to monitor baby and mom If woman is experiencing NO bleeding or very light bleeding: bed rest, no strenuous exercise or sexual intercourse for the rest of the pregnancy until baby is ready for delivery Pelvic rest: no vaginal exams or sexual intercourse, douching throughout the rest of the pregnancy (don’t want to cause injury to the vulnerable placenta presenting at the cervical opening) Intercourse post bleeding (spontaneous or during labor)Ībnormal fetal position breech (bottom first) or transverse lie (sideways)…baby’s head should normally be down but the placenta is in the way… fetal heart rate normal Nursing Interventions for Placenta Previa Visible bleeding (not concealed as in some cases with abruptio placentae) Painless vaginal bright RED bleeding (mild to profuse)Įpisodes of bleeding (not spotting) most likely during 3rd trimester…as the body prepares for the baby with the cervix thinning it causes bleeding from where it is tearing the vessels in the placenta. Scarring in the uterus from surgery : fibroid removal, c-section etc.So, in some cases the placenta previa will correct itself.Ĭauses of the placenta attaching abnormally? This will be reassessed with an ultrasound at 32 weeks. Sometimes if the placenta is found to be low lying (partially or marginal) the placenta will move upward away from the cervix as the uterus grows throughout the rest of the pregnancy. Marginal previa: placenta is near the edge of the cervical openingĬases of placenta previa vary and treatment depends on how far along the women is: Placenta previa can be seen on the 20 week ultrasound. Partial previa: placenta partially covers the cervical opening (not fully covered) Total previa: placenta completely covers the cervical opening ![]() NOT in the lower parts of the uterus, near or over the cervical opening. It should attach either to the top or side of the uterus…. Where should the placenta normally attach? An ATTACHMENT ISSUE!! It is the abnormal attachment of the placenta in the uterus near or over the cervical opening. ![]()
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