Page 112 - Critical Maternity & Newborn Health Nursing

4. Fourth - degree (Type IV= P.P. complete centralis):

The placenta covers the internal os completely whether the cervix is

partially or fully dilated

N.B. placenta previa marginals posterior is of bad prognosis than

marginals anterior because:

1. It encroaches on the true conjugate diameter delaying

engagement of the head.

2. Engagement of the head will compress the placenta against the sacrum,
causing fetal asphyxia.

Fig (13): Types of the placenta previa

Adopted from https://www.thesciencenotes.com/wp-content/uploads/2020/09/plc-1024x513.png

Diagnosis:

Symptoms:

Causeless, painless & recurrent bright-red vaginal bleeding.

• It is causeless, but may follow sexual intercourse or vaginal

examination

• It is painless but may be associated with labor pains.

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