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Case study of placenta previa
Case study of placenta previa
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Abruptio Placentae vs. Placenta Previa Abruptio Placentae vs. Placenta Previa The placenta is the first connection between mother and fetus that will be instrumental in providing life and forming a connection that will last a lifetime. The placenta is the lifeblood of the fetus- the site of nutrient absorption, gas exchange and waste elimination. When that connection has complications, the results can be devastating. In this paper we will compare two very serious complications that can occur in utero- Abruptio Placentae and Placenta Previa. We will look at the pathophysiology, diagnosis, risk factors, signs and symptoms, fetal and maternal complications and prehospital and hospital treatment for both. Placenta previa, of the two, is the least damaging to mother and fetus. In a typical pregnancy, the placenta adheres itself to the upper portion of the uterus and has no negative interaction with the cervical opening (os). With placenta previa we find abnormal implantation to the lower portion of the uterus and four degrees of previa are applicable. 1) Complete previa- the placenta completely covers the internal cervical os; 2) Partial previa- the placenta partially covers the internal cervical os; 3) Marginal previa- the edge of the placenta lies at the margin of the internal cervical os; 4) Low-lying placenta- the placenta is implanted in the lower uterine segment but does not reach the internal os of the cervix. There is one main sign associated with placenta previa and that is painless bright red vaginal bleeding. The bleeding generally starts after 20 weeks of pregnancy and is more common in the third trimester. Bleeding can range from very light to extremely heavy and may or may not recur once stopped. Rarely, contrac... ... middle of paper ... ... Retrieved May 06, 2013, from Medscape Reference: http://emedicine.medscape.com/article/252810-overview Gale Group. (2013, May). Maternal Complications from Placenta Previa. Retrieved May 06, 2013, from Galenet: http://140.234.20.9:8080/EPSessionID=838ee1ba12d4ed675b34eeada9e17bc/EPHost=galenet.galegroup.com/EPPath/servlet/HWRC/hits?docNum=A246374229&index3=KE&index2=KE&index1=FT&tcit=0_1_0_0_0_1&locID=lac73470&rlt=6&text3=&text2=&origSearch=false&text1=maternal+ Gaufberg, S. V. (2011, May 19). Emergent Management of Abruptio Placentae. Retrieved May 06, 2013, from Medscape Reference: http://emedicine.medscape.com/article/795514-overview#a1 Mount Sinai Hospital. (2013). Placenta Previa. Retrieved May 05, 2013, from Mount Sinai Hospital Joseph and Wolf Lebovic Health Complex: http://www.mountsinai.on.ca/care/placenta-clinic/complications/placentaprevia
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
In most hospital delivery rooms, the doctors will routinely clamp and sever the umbilical cord with in fifteen to thirty seconds of the mother giving birth. When clamping the cord, the doctors will clamp the cord in two places, one close to the infant and then again in the middle of the cord another clamp. By delaying the clamping, fetal blood in the placental transfusion can provide the infant with an additional thirty percent more blood volume and up to sixty percent more blood cells (McDonald, S., & Middleton, P., 2009). This reduces the risk of the hemorrhaging that could occur after birth. But with new ongoing studies, it is said that by delaying the clamping of the cor...
Eden, Elizabeth. "HowStuffWorks "Pregnancy Complications in Older Mothers" HowStuffWorks. N.p., 16 Nov. 2006. Web. 11 Apr. 2014.
...regiver sees signs of separation, they could ask you to push gently one more time to help get the placenta out. After the placenta is out you are completely done with the process of giving birth.
Deering, S.H. (2004). Abruptio placentae. Department of obstetrics and gynecology: Madigan army medical center, 2, 3.
Obstetric Ultrasound -- a Comprehensive Guide to Ultrasound Scans in Pregnancy. Mar. 2006. Web. 13 Apr. 2011. .
The opportunity to bring life into the world is a priceless moment, and for that to be threatened by a disease; such as Placenta Previa, is heartbreaking. Placenta previa is commonly described as the imbedding of the placenta over or close to the cervix. According to the Permanente Medical Group, during a normal pregnancy the placenta forms at the top part of the uterus far from the cervix. However in placenta previa, the placenta tends to attach to the lower section of the uterus either covering or partially over the cervix, making it almost impossible for a normal delivery (vaginal birth) to take place (Placenta Previa). Placenta previa complicates about 1 in every 200 deliveries and is one of the top leading causes of vaginal bleedings for the second and third trimester (Getahun). It is also related with the escalation of risks of maternal and infant illness and death (Getahun). Instead of there being a specific or many solutions over the years, doctors have come to agreement with different treatments for placenta previa. The obvious solution to placenta previa is to reduce your risks by avoiding cigarettes and any type of drugs, try to reduce your use of abortions an cesarean section, meaning no elective C-sections (The Bump). However, because the reduction in the things above is unlikely due to the mind-frame and unawareness of today’s women, the medical board has to think of alternative treatments to placenta previa, such as bed rest, constant monitoring through-out the pregnancy, and cesarean section. In this essay, I will evaluate the above listed treatments, which stage the doctor will suggest the treatment and explain which I believe is best.
Childbirth is nothing short of a miracle. The placenta—the organ connecting a developing fetus to the uterine wall and allowing for waste elimination, nutrient uptake and gas exchange via the mother's blood supply—filters most harmful substances that threaten an embryo, though some may still pass on to the fetus. These harmful substances, called “teratogens,” range from environmental chemicals to the transmission of maternal diseases, and can negatively impact the normal developmental cycle of a fetus. The title “teratogen,” however, refers to any substance or chemical exposure with the potential to cause birth defects in prenatal development. Exposure to teratogens can result in a broad spectrum of physiological and psychological issues in later life, including malformations of the body.
Association of Placenta Preparation Arts board member Nikole Keller says, “the placenta is often referred to as a filter; this isn’t an ideal term for the placenta considering its function in the body… A more suitable way of looking at it would be as a gate keeper between the mother and the fetus. The placenta’s job is to keep the maternal and fetal blood separate, at the same time allowing nutrients to pass to the fetus, gas exchange to occur, and allowing waste from the fetus to pass through the mother, . The placenta does prevent some toxins from passing through to the fetus but they are not stored in the placenta. Toxins in the body and waste from the fetus are processed by the mother’s liver and kidneys for elimination”
As defined by Lowdermilk, Perry and Cashion, preterm labor is “cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy”. Preterm birth is a dramatic event causing distress for both the child and parents. There is a significant amount of information available on the risk factors related to preterm labor. Seeing the ineffectiveness of interventions directed towards known risk factors emphasizes the lack of maternal understanding of possible underlying pathways.
Reddy, U. M., Zhang, J., Sun, L., Chen, Z., Raju, T. N., & Laughon, K. (2012). Neonatal mortality by attempted route of delivery in early preterm birth. American Journal of Obstetrics & Gynecology, 207(2). doi:10.1016/j.ajog.2012.06.023
eclampsia in a pregnant woman can put her and her unborn child at risk. A risk
These complication can be devastating for a woman who is now having a child. Placenta Previa is when the placenta partly or fully covers the opening of the cervix (“Placenta Previa”). The most common symptom is painless bleeding (Cunningham et al. 801). Placenta Previa can result in hemorrhage and preterm labor (“Placenta Previa”). Your chances of Placenta Previa increase 7-15 fold after you obtain an abortion (“Abortion Risks”).
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
Every woman when pregnant has a 3-5% chance of having a baby born with a birth defect, and these chances increase when the developing fetus/ embryos are exposed to teratogens, whether it’s intentional or unintentional (Bethesda (MD), 2006). Teratogens can cause severe birth defects, malformations, or terminate the pregnancy altogether (Jancárková, & Gregor, 2000). The placenta is known as an effective barrier from any detrimental pathogen that can potentially hurt the fetus. The timing of exposure of any teratogen is critical to the impact of prenatal development (Bethesda (MD), 2006). The most vulnerable time of the fetus for severe damage is during early pregnancy when all the major organ and central nervous system (CNS) are developing. Miscarriages have an important role in keeping a pregnancy from evolving when there is something serious going on with the developing fetus/embryo. Miscarriages are more common than we think and are the most familiar type of pregnancy loss (Bethesda (MD), 2006).