Abruptio Placentae vs Placenta Previa Nursing NCLEX Symptoms Causes Management (Placental Abruption)

Placenta previa and abruptio placentae (placental abruption) nursing NCLEX review on differences, symptoms, causes, and nursing interventions.

*What is placental abruption?* It’s the detachment of the placenta from the uterine wall BEFORE the birth of the baby. Two types of abruptio placentae include a partial or total placental abruption.

The placenta is a very important structure for maintaining the pregnancy and helps deliver nutrients and oxygen to the baby along with removing waste via the umbilical cord.

When the placenta detaches before the birth of the baby, this can lead to complications that affect both the baby and mother. The baby may lose nutrients and oxygen delivery via the damaged placenta, and the mother could experience hemorrhage along with a life threatening conditions called DIC (disseminated intravascular coagulation).

Where should the placenta normally detach from the uterine wall? After the birth of the baby (the times vary but usually within 10-20 minutes after delivery of the baby)

*What are the causes of placental abruption?*

Risk Factors for abruptio placenta include: chronic hypertension, development of preeclampsia, previous placental abruption, trauma to abdomen, cocaine or smoking, PROM (premature rupture of the membranes), multiples or many pregnancies.

Placental abruption symptoms include: dark red bleeding, extended fundal height (due to concealed bleeding), tender uterus, abdominal pain, hard abdomen, fetal distress etc.

*What is placenta previa?* It is the abnormal attachment of the placenta in the uterus near or over the cervical opening.

The placenta is a very important structure for maintaining the pregnancy and it helps deliver nutrients and oxygen to the baby along with removing waste via the umbilical cord.

Where should the placenta normally attach? The placenta should attach either at the top or the side of the uterus, NOT in the lower parts of the uterus, near or over the cervical opening.

*Placenta previa causes:*
Maternal age greater than 35 years old
Already had a baby
Drug use: cocaine or smoking
Surgery to the uterus that causes scarring like fibroid removal or c-section etc.

There are different types of placenta previa. These types include:
Total placenta previa: the placenta completely covers the cervical opening
Partial placenta previa: the placenta partially covers the cervical opening (not fully covered)
Marginal placenta previa: the placenta is near the edge of the cervical opening

Cases of placenta previa vary along with treatment. Placenta previa can be detected at the 20 week ultrasound.

Sometimes if the placenta is found to be low lying (partial or marginal previa) the placenta will move upward away from the cervix as the uterus grows throughout the rest of the pregnancy. The position of the placenta will be reassessed at the 32 week ultrasound. Therefore, in some cases of placenta previa, it will correct itself.

Placenta previa symptoms include: bright red painless bleeding, relaxed or soft uterus, and episodes of bleeding that are visible, bleeding after intercourse, abnormal baby position (breech or transverse lie).

Quiz: http://www.registerednursern.com/abruptio-placentae-vs-placenta-previa-nclex-questions/

Placenta Previa Lecture: https://www.youtube.com/watch?v=NjvjR6zuN2U

Abruptio Placentae Lecture: https://www.youtube.com/watch?v=znhSPGw8S90

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