Page 124 - Critical Maternity & Newborn Health Nursing

A. General examination:

The general condition proportionate to the amount of bleeding as all the

blood loss is revealed.

B. Abdominal examination

C. Vaginal examination: Done under the same precautions in placenta

previa. There is vaginal bleeding and if the cervix is dilated the

placenta is not felt.

Investigations: Ultrasound reveals a normally situated placenta in the
upper uterine segment with no retroplacental hematoma.

Treatment:

At home: As in placenta previa.

At hospital: Assessment, resuscitation, and ultrasound.

(I) If the patient is not in labor:

a. If the bleeding is severe  caesarean section.

b. If the bleeding is slight.

• Gestational age is completed 37 weeks or more  termination

of pregnancy by induction of labor or C.S.

• If not completed 37 weeks conservative treatment is carried out

as placenta previa till completed 37 weeks.

II)If the patient is in labor:

Delivery is carried out by amniotomy + oxytocin or C.S indicated.

Nursing Management of the abruptio placenta:

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