Placenta Previa Research Paper

Placenta Previa

The incidence of placenta previa has grown in recent years as we have seen an increase in the number and popularity of cesarean section deliveries. Placenta Previa is a condition in which the placenta implants over the cervix making vaginal birth very dangerous. The amount of cervical occlusion determines the classification of placenta previa. Marginal placenta previa, which is a low-lying placenta, partial placenta previa which partially covers the cervix, and complete placenta previa which is total occlusion of the internal cervical os. According to McKinney (2018), vaginal birth is the safest method of delivery, and cesarean section is used as the last resort when signs of maternal or fetal distress are present.

Although

However, risk factors that increase the likelihood of having this condition include maternal drug use, multiparity, and previous uterine surgeries.

Implantation ordinarily takes place in the fundus of the uterine endometrium. Interestingly, with placenta previa, implantation occurs in the lower uterine endometrium. Multiple pregnancies, as well as previous Cesarean section delivery, can increase the risk of placenta previa as much as 60% (Beddall, 2015). Scar tissue formation from these conditions can lead to poor vascularization of the uterine fundus. Inadequate perfusion of the uterine fundus may lead to implantation in the lower uterine endometrium where blood supply is abundant.

The uterus is relatively small early in pregnancy so it is common to note a low-lying placenta on ultrasound. However, as the uterus increases in size to accommodate the developing fetus the placenta begins to migrate toward the fundus. If the placenta remains low lying into the third trimester this results in a condition known as placenta previa and is classified according to the degree of cervical

914).

 Apply an external fetal heart rate monitor and tocodynamometer to monitor the fetal heart rate pattern and uterine contractions.

 Obtain a complete blood count, type & crossmatch and coagulation profile in case blood transfusion is needed (Carpenito, 2016, p. 915).

 Assess the mother for bleeding every 15 minutes. Note characteristics, odor and weigh peri pads to quantify blood loss.

 Administer oxygen and intravenous (IV) fluids as ordered. McKinney (2018) recommends administering oxygen by face mask at 8-10 L/min and administration of a bolus dose of IV fluids as ordered to increase blood flow to the fetus.

 Start a secondary IV line in case the patient needs a blood transfusion.

 Monitor urine output and insert an indwelling catheter as ordered to assure accurate measurement of urine output which is an indicator of renal function.

 Instruct the mother to remain on bed rest and position in lateral recumbent position. This position displaces the uterus which reduces compression on the vena cava and increases blood flow to the fetus (Carpenito, 2016, p.