Difference between Placenta Previa and Abruptio Placenta
Difference Between Placenta Previa and Abruption Placenta
|Category||Placenta Previa||Abruptio Placenta|
|Problem||Low implantation of the placenta||Premature separation of the placenta|
|Incidence||It occurs in approximately 5 in every 1000 pregnancies||It occurs in about 10% of pregnancies and is the most common cause of perinatal death.|
|Bleeding||Always present||May or may not be present|
|Color of blood in bleeding episodes||Bright red||Dark red|
|Pain during bleeding||Painless||Sharp, stabbing pain|
Placenta previa is the low implantation of the placenta. The types of placenta previa are the following:
- Low-lying placenta previa – the implantation took place in the lower portion rather than the upper portion of the uterus.
- Marginal placenta previa – the placental edges are approaching the cervical os.
- Partial placenta previa – a portion of cerval os is occluded by the placental portion.
- Total placenta previa – implantation that totally obstructs the cervical os.
- It occurs in approximately 5 in every 1000 pregnancies
- Increased parity
- Advanced maternal age
- Past cesarean births
- Past uterine curettage
- Multiple gestation
Signs and Symptoms
- Bleeding – bright red blood. The lower uterine segment begins to differentiate with the upper segment later in pregnancy. Placenta has the inability to stretch to accommodate the differeing shape of the lower uterine segment or the cervix, thus, abrupt and bright red bleeding occurs.
- Painless bleeding
- Sudden bleeding
- Place the woman immediately on bed rest in a side-lying position.
- Weight perineal pads.
- NEVER attempt a pelvic or rectal examination because it may initiate massive blood loss.
In this condition, the placenta has been implanted correctly, however the placenta separates prematurely.
- It occurs in about 10% of pregnancies and is the most common cause of perinatal death.
- High parity
- Advanced maternal age
- A short umbilical cord
- Chronic hypertensive disease
- Pregnancy-induced hypertension
- Direct trauma
- Vasoconstriction from cigarette use
- Thrombophilitic conditions that lead to thrombosis such as autoimmune antibodies
Signs and symptoms
- Sharp, stabbing pain high in the uterine fundus (during initial separation)
- Tenderness felt on uterine palpation
- Heavy bleeding (not readily apparent). Blood can either pool under the placenta and be hidden from view. External bleeding is only present if the placenta separates first at the edges and blood escapes freely from the cervix.
- Hard, boardlike uterus with no apparent or minimally apparent bleeding
- Dark red blood (in bleeding episodes)
- Fluid replacement
- Oxygen by mask
- Monitor FHR
- Keep the woman in a lateral position
- DO NOT perform any vaginal or pelvic examinations or give enema
- Pregnancy must be terminated because the fetus cannot obtain adequate oxygen and nutrients. If birth does not seem imminent, cesarean birth is method of choice for delivery.