Abruption Placenta & Placenta Previa.pptx

Placenta previa

1. Abruption Placenta *Prepared By Majd Alhijazi *Miss : Ghadeer Zayadeen Dr.mona almalik

2. Objective * At the end of this seminar we will able to  Identify  : - Definetion - Pathophysiology .  - Classification . - Causes , risk factors and complication -Signs and symptoms . - Laboratory and Diagnostic Testing -Nursing Assessment and Nursing medical management . - Pt education .

3. Definition : Placenta: The placenta is an organ that develops in uterus during pregnancy. This structure provides oxygen and nutrients to growing baby and removes waste products from baby's blood. The placenta attaches to the wall of uterus, and baby's umbilical cord arises from it. The organ is usually attached to the top, side, front or back of the uterus.

4. Abruption Placenta

5. Abruption Placenta Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby's supply of oxygen and nutrients and cause heavy dark bleeding in the mother. It can occur at any time after 20 weeks of pregnancy, but it’s most common in the  third trimester .

6. the abruption start with degenerative change in the small maternal arterioles , resulting in : thrombosis ,, and possible rupture of a vessels . Bleeding from the vessels forms a retroplacental clot . The bleeding causes increase pressure behind the placenta and result in separation . Pathophysiology

7. Abruptio placentae is classified to the : 1. extent of separation 2. the amount of blood loss from maternal circulation includs :

8. Abruptio placentae also may be classified as partial or complete , depending on the degree of separation .  

9. Causes *The cause of placental abruption is often unknown. *Possible causes include : trauma or injury to the abdomen or HTN or smoking

10. Risk factors maternal smoking maternal age (over 35 years old ). poor nutrition. multiple gestation sever trauma ( auto accident ) cocaine use alcohol ingestion preeclampsia

11. Signs and symptoms Rapid contraction

12. maternal : - sever hemorrage - need for blood transfusion - emergency hysterectomy Complication

13. Fetal : - low birth weigh . - preterm delivery . - Decreased oxygen to the baby, which could lead to brain damage - stillbirth . Complication

14. Medical history Physical examination, including checking the tenderness and tone of the uterus CBC Fibrinogen levels—typically are increased in pregnancy ( PT ) , ( PTT ) ultrasound CT scan is more reliable method for evaluation of placenta abruption . Laboratory and diagnostic testing :

15. Nursing Assessment

16. palpation of the uterus for tenderness, consistency, and frequency and duration of uterine contractions   auscultation of fetal heart sounds and ask about fetal movement, recent changes in activity patterns .

17. Nursing Management Obtain maternal vital signs frequently ,even 15 min .  Monitor the amount and characteristics of any vaginal bleeding as frequently as every 15 to 30 minutes.  Communicate empathy and understanding of the client’s experience, and provide emotional support.

18. Medical management To avoid a worsening condition, these medical procedures are implemented for both the mother and the fetus : 1- Intravenous therapy : Once the woman starts to bleed, the physician would order a large gauge catheter to replace the fluid losses. 2- Oxygen inhalation : Delivered via face mask, this would prevent fetal anoxia. 3- Fibrinogen determination : This test would be taken several times before birth to detect DIC.

19. Health education

20. Nursing care plane planning Evaluation Rationale Nursing Interventions Nursing Diagnosis Goal : client will be relief or control of pain . Outcome : Patient will report relief or control of pain. . - The patient will be able to feel comfortable and verrbalize reduce of pain . To help determine the possibility of underlying condition or organ dysfunction requiring treatment. To maintain an acceptable level of pain. To promote non pharmacological pain management. Assess for referred pain as appropriate. Administer analgesics as indicated. Provide comfort measures, quiet environment, and calm activities. Acute Pain RT Sudden separation of placenta AMB Sharp, stabbing pain high in the uterine fundus Uterine tenderness

21. summary

22. Placenta abruption Placenta previa manifestation Sudden insdious Onset Can be concealed or visible Always visible ,slight, then more profuse Type of bleeding dark Bright red Blood description Constant, uterine tenderness on palpation None (painless) Discomfort / pain Firm to rigid Soft and relaxed Uterine tone Fetal distress or absent Usually in normal rang Fetal heart rate