placenta previa

What does placenta previa mean?

What does placenta previa mean? The normal attachment of the placenta lies in the posterior wall, anterior wall or lateral wall of the uterine body. If the placenta attaches to the lower part of the uterus or covers the cervical internal orifice, the position is lower than the exposed part of the fetus, called placenta previa.

How does placenta previa happen? Endometrial damage is the main cause of placenta previa, such as cesarean section, induced abortion, uterine fibroids surgery and other women, endometrium and basal layer will be damaged, after pregnancy, local blood supply difference, the fetus in order to obtain more nutrition, the placenta will automatically increase the area, Thus covering the inside of the uterus, forming a placenta preposition.

After 28 weeks of pregnancy, the placenta enlargement rate slows down, the uterus enlargement speed increases, the placenta and cervical orifice relative position changes, once the placenta and cervical peeling off, easy to cause pregnant women bleeding. Therefore, mothers who are pregnant with a second child, especially the first, should pay special attention to the birth test to determine whether placenta previa is present.

Placenta previa is the most dangerous in several months.

Placenta previa is the most dangerous month? Once a pregnant woman is diagnosed with placenta previa after 28 weeks of pregnancy, the doctor will wear the “high-risk pregnancy” hat. Therefore, pregnant women diagnosed with placenta previa will be very worried, especially the central placenta previa (placenta completely covered the uterine orifice), after 34 weeks of pregnancy after the occurrence of premature birth, bleeding rate is higher.

All the organs of the 34-week-old fetus are mature, for pregnant women with placenta previa, can be active surgery is not passive to emergency.

Placenta previa how to do

What if there is placenta previa? For the treatment of placenta previa, there is a complete set of guidelines for obstetric guidance. Placenta previa should also bear in mind the following 5 points:

1, the family must be accompanied by a pregnant woman. There is no sign of bleeding from placenta previa.

2, diet is more exquisite, avoid constipation cause abdominal pressure increase and cause placenta stripped and bleeding.

3, pregnant women must not have sexual life.

4. Regular maternity check-up, to determine what type of placenta previa they belong to, if it is central, obey the doctor’s advice, when admitted to hospital.

5, family members donate blood in advance to avoid high blood transfusion during transfusion.

Treatment of placenta previa

Expectation therapy

Pregnancy less than 36 weeks, fetal weight less than 2300 g, vaginal bleeding volume is not much, pregnant women in good general condition, fetal survival, can take anticipatory therapy.

1. Absolute bed rest, can be given sedatives, such as Lumina 0.03, or 10 mg Limonin, or 5 mg diazepam, oral 3 times a day.

2, inhibit uterine contraction, salbutamol 2.4-4.8mg, 4-6 hours, once the contraction is stopped after the amount of maintenance.

3, correct anemia, ferrous sulfate 0.3, 3 times per day, and blood transfusion if necessary.

4. Antibiotics (penicillin, cephalosporin) prevent infection.

5, dexamethasone 10mg, intramuscular injection or static push, 1 times / day, for three consecutive days, to promote fetal lung maturity.

6. Close observation of the condition, while conducting relevant auxiliary examinations, such as B-ultrasound, fetal maturity, such as massive bleeding, repeated bleeding, as appropriate termination of pregnancy.

Two. Termination of pregnancy.

Positive measures should be taken to terminate pregnancy, such as massive hemorrhagic shock at admission, massive hemorrhagic shock during placental anticipation therapy, recurrent hemorrhage near the expected period of labor, or more postpartum hemorrhage. There are two ways to terminate pregnancy:

1. During cesarean section (the main method of treating placenta previa), shock should be corrected actively before operation, and the volume of blood should be supplemented by transfusion and blood transfusion.

2. Vaginal delivery: vaginal delivery is the use of the placenta prophase compression placenta hemostasis, this method is only applicable to marginal placenta previa and the fetus as the head. In postpartum bleeding, but not much blood, maternal general good, smooth delivery process, estimated in a short period of time can end the delivery. After deciding the vaginal delivery, the operation to break the membrane, after the rupture of the fetal head down, compression of the placenta, to stop bleeding, and promote uterine contraction, accelerate delivery, this method is better for postpartum women.

Nursing care of placenta previa

The treatment principle of placenta previa is hemostasis and blood tonic, such as less bleeding, the fetus is not full term, can use expectant therapy, pregnant women should maintain a balanced state of mind, absolute bed rest, prohibit sexual intercourse. Bleeding can stop, ambulation, convenient treatment and no bleeding of pregnant women can be allowed to discharge. If a pregnant woman suffers from anemia or even shock caused by repeated massive bleeding, the pregnancy should be terminated, whether the fetus is mature or not, for the safety of the mother. If the fetus reaches 36 weeks, the fetal maturity examination suggests that the fetus should be terminated. Such as placenta previa, fetal head can reduce the placenta, can effectively stop bleeding. This kind of situation may deliver through the vagina, but when delivers must prepare the blood, in other circumstances terminates the pregnancy the way takes the cesarean section as the first choice.

Nursing principles for placenta previa:

1. Avoid carrying heavy objects: in the middle and late pregnancy, the details of life should be more careful, should not carry heavy objects or abdominal exertion, in order to avoid danger.

2. Suspension of sexual behavior, as the case may be: If bleeding symptoms or into the late pregnancy, sexual behavior should not be appropriate, in addition, mild placenta previa patients, but also to avoid too intense sexual behavior or oppressive abdominal movements.

3. Haemorrhage should be immediately consulted: symptoms of bleeding, no matter how much blood should be immediately consulted, if encounter a new obstetrician, should also take the initiative to inform the placenta previa problem.

4. Don’t be too tired: Pregnant women with high-risk pregnancy should rest more to avoid overwork and affect the smooth delivery.

5. Pay attention to fetal movement: pay attention to the normal fetal movement every day, if you feel that the fetal movement is significantly reduced, you need to seek medical examination as soon as possible.

6. Choose the appropriate hospital for obstetric examination: If the third and fourth grade placenta previa patients, it is best to choose a large hospital or medical center for obstetric examination, once the occurrence of premature delivery, massive bleeding and other problems, can be dealt with immediately.

7. Don’t over-exercise: Excessive exercise may also cause placenta previa bleeding or other symptoms, therefore, this type of pregnant women should not be too intense exercise.

Can placenta previa give birth

Placenta previa should be selected according to the type of delivery. If it is complete and partial placenta previa to choose cesarean section, because complete and partial placenta previa occurs when completely or partially covered the cervical orifice, resulting in obstruction of the soft birth canal can not be spontaneous delivery, and must be before the occurrence of uterine contraction to the hospital cesarean section termination of pregnancy, otherwise once the occurrence of uterine contraction after The separation of placenta from the uterine wall causes massive vaginal bleeding, which is very dangerous for pregnant women and fetuses.

If it is marginal placenta previa can choose vaginal delivery, but only suitable for those who are already in labor, vaginal bleeding volume is not much, the general condition is good, the labor process is progressing smoothly, it is estimated that the delivery can be ended in a short time. If the process of delivery in the process of smooth progress, increased vaginal bleeding, it is necessary to immediately switch to cesarean section.

Treatment of placenta previa during childbirth

1. Absolute rest in bed can be given to sedatives.

2, inhibit uterine contraction.

3, correct anemia and blood transfusion if necessary.

4, use antibiotics (penicillin, cephalosporin) to prevent infection.

5, promote fetal lung maturation.

6. Close observation of the condition, while conducting relevant auxiliary examinations, such as B-ultrasound, fetal maturity, such as massive bleeding, repeated bleeding, as appropriate termination of pregnancy.