Case Presentation on

Placenta Previa in
Pregnancy
Presented by
Ankana Ghosh Dey
Ambika Ghosh
Runa Dey
LipikaMallick
Introduction
Definition
Patient Picture
Types
 Pathophysiology

Predisposing factor. Precipitating factors

🔽
Increase progesterone and oestrogen level
🔽
Preembryonic stage
🔽
Production of fertilized ovum
🔽
 Implantation in the uterus,
🔽
Embryonic stage
🔽
Placent are arise from the tropoblast tissue
🔽
Insufficient blood
Placenta migrates to where there is sufficient blood supply
🔽
Placenta resides in the lower

Total ↗️Partial ↗️ Marginal ↗️Low lying

 Clinical Features
Symptoms:
Vaginal Bleeding
👉 Sudden Onset
👉 Painless
👉 causeless
👉 Recurrent
Signs
✨General condition and anaemia proportionate to blood loss

✨ Abdominal examination
👉 height of uterus proportionate to gestational age
👉 Uterus feels soft and relaxed
👉 Mal presentation is common
👉 Fetal heart sound is usually present
Cont….
Vulval inspection.
👉bright red or dark colored bleeding
👉 Placenta is felt on lower segment
💥vaginal examination must not be done
 Complication
Maternal Complication
During Pregnancy
 Malpresentation
 Premature labor
During Labor
 Early Rupture of membrane
 Cord prolapse
 Slow dilation of cervix
 Interapartum hemorrhage
 Operative interference
 PPH
During Puperium
 Sepsis
 Sub-Involution
 Embolism
 Fetal Complication
Low birth weight
Fetal growth Restriction
Fetal Asphyxia
Birth Injuries
Congenital Malformation
Diagnostic Evaluation

Trans abdominal Sonography

Trans vaginal Sonography(TVS)
Trans Perineal Sonography
Color Doppler
MRI
Management
 Prevention
 Immediate management
 Expectant management
 Active management
 Nursing Management
 Prevention
Regular Antenatal Care
Routine Ultrasound
Significance of warning haemorrhage
If bleeding at home
Put her on bed immediately
Assess for blood loss
Transfer mother to hospital
Immediate Attention
Note amount of blood loss
Take blood samples
Large bore cannulation & NS infusion
Gentle Abdominal Palpation
Inspection of Vulva
Schematic Management
 CONTD..

Active management

Caesarean delivery
Placental edge is within 2 cm from the internal os: in this case no
internal examination is performed and caesarean section is considered as
the best choice.
 Nursing Management
Nursing Diagnosis
  Decreased cardiac output related to blood loss as evidenced by increase in
heart rate.
 Ineffective tissue perfusion related to decrease in Hb% in blood as evidenced
by dyspnea.
 Deficient fluid volume related to Blood Loss as evidenced by vital signs
changes.
 Fear related to outcome of pregnancy as evidenced by facial expressions of the
mother or frequent questioning.
 Impaired fetal gas exchange related to decreased placental surface area as
evidenced by changed in FHS.
Prognosis
Maternal

Fetal
Any question
Questionnaires
1.What is the Significant characteristic of vaginal bleeding in
Placenta Praevia.
a) Odorless
b) Painless
2.What will be the fetal complication in Placenta Previa.
c) Low birth weight baby
d) Big baby
THANK YOU