For the NCLEX, you will need to know the difference between placenta previa and abruptio placentae. Placenta previa and abruptio placentae are maternity complications that a nurse must understand in order to provide adequate nursing care.
Below you will learn:
What is placenta previa?
What are the signs and symptoms of placenta previa?
What is the treatment for placenta previa?
What is the nursing intervention for placenta previa?
What are the complications of placenta previa?
What is abruptio placentae?
What are the signs and symptoms of abruptio placentae?
What is the treatment for abruptio placentae?
What is the nursing intervention for abruptio placentae?
What are the complications of abruptio placentae
What is Placenta Previa?
Placenta previa is when the mother’s cervix is covered by the placenta. Bright red vaginal bleeding can occur early in pregnancy, stop, and then start again. Because the placenta is tearing away from the uterine wall, bleeding occurs.
Types of Placenta Previa:
Marginal placenta previa
- Placenta implantation in the margin of the cervical os
- Does not cover the os
Low-lying placenta previa
- Placenta implantation in the lower uterine segment
- Does not reach the cervical os
Partial placenta previa
- Placenta occludes the cervical os partially
Total placenta previa
- Placenta completely covers the internal cervical os
What are the signs and symptoms of Placenta Previa?
- Painless
- Bright red vaginal bleeding
What is the treatment for Placenta Previa?
Placenta previa can be resolved, but if it occurs in the second half of pregnancy, an emergency C-section is usually required. The physician must be notified immediately. It can be resolved easier in the first half of pregnancy.
What is the nursing intervention for Placenta Previa?
- Ultrasound examination is done every 2 to 3 weeks.
- Cervical examination should not be performed. It is contraindicated and can cause hemorrhage or death.
- Patient should be placed on bed rest.
- Physician must be notified immediately.
What are the complications of Placenta Previa?
- Fetal anemia
- Fetal distress
- Slow fetal growth
- Shock
- Death
What is Abruptio Placentae?
Abruptio placentae occurs when the placenta detaches from the uterus. A pregnant patient with a history of hypertension has a risk for abruptio placentae. It can occur from amniotic fluid loss or from an injury to the abdomen.
What are the signs and symptoms of Abruptio Placentae?
- Vaginal bleeding
- Abdominal pain
- Lower back pain
- Uterine tenderness
What is the treatment for Abruptio Placentae?
The placenta cannot be reattached to the uterus. Hospitalization may be required depending on whether or not the fetus is in distress. Bed rest is recommended if the bleeding stops and the fetus is in stable condition. An emergency C-section is required if the pregnancy is already at full-term and bleeding is severe.
What is the nursing intervention for Abruptio Placentae?
- The nurse should not perform cervical examination. It is contraindicated and can cause hemorrhage or death
- When diagnosed with abruptio placentae, the nurse must assess the fetal heart tones immediately.
- The physician must be notified immediately.
What are the complications of Abruptio Placentae?
- Shock
- Disseminated intravascular coagulation
- Kidney failure
- Premature birth
- Stillbirth
- Lack of oxygen
