A condition in which the placenta is implanted close to or covers the cervical os
Risk Factors
- Maternal age >35 years
- Previous cesarean birth or uterine incision
- Maternal smoking Multiples
- Closely spaced pregnancies
- Prior placenta previa
3 Types
Total placenta previa: Rarely resolves
Partial placenta previa: Sometimes resolves
Marginal placenta previa: Sometimes resolves
Signs & Symptoms
- Painless, bright red
- Soft uterus
- Fundal height higher than expects
- Fetal malpresentation
Digital examination of the cervix is deferred until placenta previa has been excluded
Diagnostic test of choice is transvaginal ultrasound
First bleeding episode does not harm the fetus (usually)
Nursing Interventions
- Assess bleeding (count pads)
- Fundal height
- Leopold’s maneuver
- Vital signs
- IV fluids
- Anti-D immunoglobulin (RhoGAM)
- Bed rest
- Pelvic rest
- FHR monitoring
- Ultrasound
- Hemoglobin & Hematocrit
- Blood type & Rh factor
- Corticosteroids
- C-section
- Blood transfusion
Mnemonic
Painless bright red
Replace blood loss
Evident in lower uterine segment
Vitals indicate shock
Insect FHR
Avoid vaginal exams