Placenta previa and placenta abruptio

RedheadErin said:
At what point during the delivery do you know either of these conditions exists?
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1. Previa: After the ultrasound prior to entering labor.

2. Fetal distress on the monitor.


Oh, prehospital? Yea... those answers aren't helpful.
 
My problem is, I am preparing for my wildcard exam on tuesday. I have a list of some 60 topics, ONE of which I will have to give a 10-minute presentation on. "OB Delivery with Placenta Previa" and "OB Delivery with Placenta Abruptio" are 2 of the 60 topics.

My book covers a normal delivery in excruciating, redundant detail, but gives about 50 words each to P. Previa and P. Abruptio. I have no idea at all how I would handle a delivery with either of these conditions.

All I can think to do is treat for shock, rapid transport, and keep track of how many pads they soaked. What else could I do?
 
RedheadErin said:
My book covers a normal delivery in excruciating, redundant detail, but gives about 50 words each to P. Previa and P. Abruptio. I have no idea at all how I would handle a delivery with either of these conditions.
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1. Scheduled c-section.

2. Vaginal delivery with coag panels, fetal monitoring, and an OB/Gyn ready to perform a crash c-section if the baby shows distress.


Prehospital? PUHA.
 
The information in your book probably isn't all that excruciating...

What are these wildcards you speak of? Are you presented with a topic and expected to give a presentation on the spot?
 
It is excruciating, especially when you have to read through all the redundancies to find one little thing you are looking for.....

The wildcard is the first part of my final exam (along with a written exam and a practical.) We have this long list of possible topics and we are expected to be prepared for all of them. Then on test day, we will each draw a topic out of a hat or something and have to give a 10 minute presentation on the spot, using only materials found in the classroom. No notes. I don't think we will even have more than a minute or two of prep time, if that much.

SOmetimes I think my instructor is psychotic, or at least a little strange.....:blink:
 
Assuming your instructor gave you adequate instruction throughout the course, I like him. :) He expects you to know your stuff instead of pushing everyone through.
 
I like him, too, for the same reasons. But his lecture style is a little scattered, and he departs drastically from the book. This won't be the first time he has expected us to know something nobody remembers hearing.

But back to my original problem:

I show up at somebody's door, she is pregnant and something is wrong. Will either or both of these conditions cause vaginal bleeding? Will they force a premature labor? Assuming she has not had great prenatal care, is it possible to know if she has a placenta previa or a placenta abruptio? Most importantly, what do I do for her?
 
Treat for shock, rapid transport, keep her warm, and monitor for signs of imminent delivery.

Placenta abruptio- can be very painful and heavy bleeding.

Previa- usually painless light bleeding.

That's all you can do.
 
Thanks! I have wasted the better part of an evening trying to figure that out.

These are both conditions of the 3rd trimester, right? Would I see this if the baby was full term and ready to deliver, or does it usually accompany or cause a premature birth?

And I wouldn't be trying to deliver a baby in this case, I would be trying to get her to the hospital as fast as I could.

Just say, the contractions are coming fast and hard and delivery is imminent or the baby is crowning. There a bunch of blood and a history consistent with p. abruptio, or else her doc told her she has placenta previa? Then what?
 
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Drive faster. Elevate the pelvis with padding. If the baby is crowning and you see the head. Then prepare for delivery and just do the best you can. There's gonna be a lot of blood with abruptio. My patient that I had. It looked like a murder scene in the apartment and in the back of the truck. She had two large bore IVs lots of fluids and lots of diesel. There is nothing we can do prehospital to help save this patient or the baby.

Just supportive care and transport.
 
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