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3RD Trimester Bleeding

The document discusses third trimester bleeding, specifically focusing on placenta previa and abruptio placenta. It outlines risk factors, clinical classifications of symptoms, and management strategies for both conditions. Key management includes addressing known risk factors, monitoring blood loss, and determining the appropriate intervention based on the severity of the situation.

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ferrerjericho300
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12 views46 pages

3RD Trimester Bleeding

The document discusses third trimester bleeding, specifically focusing on placenta previa and abruptio placenta. It outlines risk factors, clinical classifications of symptoms, and management strategies for both conditions. Key management includes addressing known risk factors, monitoring blood loss, and determining the appropriate intervention based on the severity of the situation.

Uploaded by

ferrerjericho300
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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3RD TRIMESTER BLEEDING

PLACENTA PREVIA
PREVENTION
IMMEDIATE ATTENTION
EXPECTANT MANAGEMENT
EXPECTANT MANAGEMENT
ACTIVE MANAGEMENT
ACTIVE MANAGEMENT
ACTIVE MANAGEMENT
NURSING MANAGEMENT
NURSING MANAGEMENT
NURSING MANAGEMENT
NURSING MANAGEMENT
ABRUPTIO PLACENTA
RISK FACTORS
1. PREVALENCE IS MORE WITH:
A. High birth order pregnancies with gravida 5 and
above
B. Advancing age of the mother
C. Poor socio-economic condition
D. Malnutrition
E. Smoking
RISK FACTORS
2. HYPERTENSION IN PREGNANCY
A. Pre-eclampsia
B. Eclampsia
C. Gestational HTN
D. Essential HTN
RISK FACTORS
3. TRAUMA
A. Attempted external cephalic version specially
under anesthesia using great force
B. Road traffic accidents/ blow on the abdomen
C. Needle puncture at amniocentesis
RISK FACTORS
4. SUDDEN UTERINE DECOMPRESSION
A. Delivery of the first baby of twins
B. Sudden escape of liquor amnii in hydramnios
C. PROM
RISK FACTORS
5. SHORT CORD
6. SUPINE HYPOTENSION SYNDROME
7. PLACENTAL ANOMALY: CIRCUMVALLATE PLACENTA
8. SICK PLACENTA: POOR PLACENTATION
9. FOLIC ACID DEFICIENCY
10. OTERINE FACTOR: IMPLANTED OVER A SEPTUM
11. COCAINE ABUSE: INC.BP AND VASOSPASM
12. PRIOR ABRUPTIO
TYPES
CLASSIFICATION
CLINICAL CLASSIFICATION OF SYMPTOMS
GRADE 0:
• clinical features may be absent
• The dx is made after inspection of placenta following delivery
GRADE 1:
• Vaginal bleeding is slight
• Uterine tenderness may be minimal or absent
• Maternal BP and fibrinogen levels unaffected
• FHT is good
CLINICAL CLASSIFICATION OF SYMPTOMS
GRADE 2:
• Vaginal bleeding is mild to moderate
• Uterine tenderness
• Maternal BP is maintained
• PR increase
• Fibrinogen level may be decreased
• Shock is absent
• Fetal distress or fetal death
CLINICAL CLASSIFICATION OF SYMPTOMS
GRADE 3:
• Vaginal bleeding is moderate to severe or may be concealed
• Uterine tenderness is marked
• Shock is pronounced
• Fetal death
• Blood coagulation and renal problem
MANAGEMENT
1. Elimination of known factors
2. Correction of anemia: folic acid
3. Prompt detection and institution of the therapy
MANAGEMENT
1. Amount of blood loss
2. Maturity of the fetus
3. Presence of complication
4. Type and grade of the abruption placenta
MANAGEMENT
1. Immediate delivery
2. Management of complications

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