Placenta Previa

Placenta previa is a condition in which the placenta implanted improperly in the lower uterine segment near or over the internal cervical os.

Types of Placenta Previa:

1. Total: the internal os is covered entirely by the placenta when the cervix is dilated fully
2. Partial: the internal os is covered incompletely
3. Marginal: only an edge of the placenta extends to the internal os
4. Low-lying placenta: the placenta is implanted in the lower uterine segment but does not reach the internal os

Signs and Symptoms:

• Painless red vaginal bleeding occur in the last half of pregnancy
• Uterus is soft, relaxed, and non-tender
• Fundal height may be greater than expected for gestational age

Nursing Interventions:

• Interventions depend on the classification of the previa and gestational age of the fetus
• Monitor maternal vital signs, fetal heart rate, and fetal activity
• Prepare for ultrasound
• Avoid vaginal examination
• Bed rest in a left leteral position
• Monitor amount of bleeding (shock)
• Administer IV fluids, blood products, or tocolytic medication as prescribed
• Cesarean section may be performed if bleeding is heavy
• Administer Rh immune globulin if the mother is Rh-negative and has not been given the injection at 28 weeks of gestation