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cce_obstetrics_placenta previa ((type 4 (MAJOR total placenta previa…
cce_obstetrics_placenta previa
history
investigations
blood
cbc, clotting profile, cross-match
imaging
fetal parameters (liquor, placenta previa, retroplacental clot) TAS
(cervical length) TVS
fetal
CTG
physical examination
further assess
general
(resuscitation) (vitals) (Doptone) pallor
abdominal
(lie, presentation, engagement) (uterine tenderness, woody hard uterus) (Doptone: fetal heart rate)
speculum
(cervical status) (genital tract injury) (active bleeding)
immediate
Doptone
vitals
airway breathing
circulation
(assess amount of blood loss)
x symptomatic
30 minutes' reach of hospital
rapid transportation
outpatient
mode of delivery
34 weeks, elective Caesarean section (heavy bleeding, placenta accreta)
more than 2 cm away from os and engaged
vaginal delivery (if no contraindications to vaginal delivery)
x symptomatic
admit if vaginal bleeding
USG at 34 weeks
x coitus
v symptomatic
v uterine contraction
hospitalize until delivery
tocolytics for time of 1 course of dexamethasone
v symptomatic
Rhesus -ve: anti-D immunoglobulin
USG at 34 weeks
dexamethasone
type 4
MAJOR total placenta previa (totally cover os)
type 3
MAJOR partial placenta previa (partially cover os)
type 2
MINOR marginal placenta previa (margin of os)
type 1
MINOR low-lying placenta previa (within 5 cm)
also this is what to do in emergency