Question

Placenta Previa

Steps for pamphlet/ brochure

1. Define the population that the project addresses.

2. Outline the information that the client would need: Understanding of the problem/issue, instructions about care, medications and follow-up.

3. Describe the information that should be addressed during a patient education session:

a. Medication instructions

b. Follow-up plans

c. Anticipatory guidance

4. Make the information brief and understandable! The language should be at a fourth-grade reading level.

5. Design the format applicable to the population/patient. Be sure to include graphics that illustrate the material.

Answer 1

Placenta previa

1. A condition in which the Placenta partially or wholly blocks the neck of uterus thus interfering with the normal delivery of a baby. Placenta previa occurs when the placenta covers the opening in the Mother's cervix. Placenta previa risk factors include a previous delivery, age older than 35 and the history of previous surgeries ,such as a caesarean section or uterine fibroid removal.

2. The most important symptom in Placenta previa is painless vaginal bleeding after 20 weeks .however there are causes of vaginal bleeding other than Placenta previa. All bleeding during pregnancy should be reported to your doctor for prompt investigation and treatment.

Why the bleeding happens

During the later stages of pregnancy, the bottom part of the uterus thins and spreads to accommodate the growing baby. If the placenta is anchored to the bottom of the uterus this thinnig and spreading separate the Placenta and causes bleeding .

sexual intercourse can also cause bleeding from the Placenta previa in later pregnancy .during labour the cervix thins and dilates which would normally allow the baby to exit into the vagina. In Placenta previa, the dilation of the cervix further tears the Placenta and causes bleeding.

Possible complications

* major hemorrhage for the mother

* shock from loss of blood

* fetal distress from lack of oxygen

* premature labour or delivery

* health risk to the baby if born prematurely

* emergency cesarean delivery

* hysterectomy if the Placenta fails to come away from the uterine lining

* blood loss for the baby

* death

Causes and risk factors

* low implantation of the fertilized egg

* abnormalities of the uterine lining such as fibroids

* scarring of the uterine lining

* abnormalities of the placenta

* multiple babies such as twins

* multiple pregnancies -A woman who has already had six or more deliveries as a risk of one in 20.

Treatment

At home

* bed rest

* arrange for immediate transfer to the hospital

* no vaginal examination and no vaginal pack. only a sterile vulval pad is applied

*No oral intake as anaesthesia may be required

*antishock measures as pethidine I'M, Fluids and blood transfusion may be given in the way to the hospital if bleeding is severe

At hospital

* close monitoring such as using a fetal monitor and regularly checking the Mother's vital signs

* blood transfusion for the mother

* avoiding any activity that triggers uterine contractions or irritates the cervix such as sexual intercourse orgasms.

Medications

*Tocolytics

* corticosteroids- are indicated at 24 to 34 weeks gestation given the higher risk of premature birth.

*adrenergic agonists

prevention

Placenta previa cannot typically be prevented .In some cases, risk factors for the development of placenta previa can be eliminated Such smoking cessation.