Question

Ann works full-time as a crossing guard at an elementary school. She is a married 34 year-old G1P0, 32 weeks pregnant woman and reported to her OB this morning that she has been experiencing some “spotting”. She has just been told by her OB that she as PLACENTA PREVIA and has been sent home on bedrest.
• What is Placenta Previa?

• How may this diagnosis affect the rest of her pregnancy? Her home life/ emotional/ financial/ sexual needs?

• Ann should notify her doctor if she experiences what symptom/sign?

• How will this affect the delivery of her baby?

• What concerns might you have about her delivery?

• What will her postpartum recovery be like afterwards?

• As her postpartum nurse, describe your plan of care for her including any medications/ labs/ nursing diagnoses that you feel may be relevant.

Answer 1

Placenta praevia is the condition in which the placental implantation occurs in the lower uterine segment, either partially or fully covering the cervical os. This condition predisposes the patient for antepartum hemorrhage and can possibly result in pregnancy loss.

The type of placenta praevia also determines the susceptibility for complications.

• The diagnosis will change the course of Ann's pregnacy plan. She will be advised rest as well as more frequent moinitoring for symptoms like bleeding and fetal well being.
• she may need caesarean section depending upon the presentation during labor. Elective caesarean may be required as the placenta may block the progress of labor or can lead to severe hemorrhage.
• Concerns during delivery include blood loss, cord prolapse, obstructed labor etc.
• She may need caesarean section in case of which prolonged hospital stay will be required compared to normal vaginal delivery.
• USG scans for monitoring fetal growth and determining position of placenta, iron supplements to incraese blood volume, more frequent monitoring, bed rest.