A Midwifery care for pregnant women with placenta previa totalis at Dr. WAHIDIN SUDIROHUSODO MOJOKERTO
Placenta previa totalis of pregnancy
Keywords:
antepartum hemorrhage, placenta previa, pregnancyAbstract
Placenta previa is one of the causes of bleeding in pregnancy. Placenta previa is the placenta implanting in the lower uterine segment so that it covers all or part of the internal uterine os. In Indonesia, the prevalence of placenta previa ranges from 2.4% - 3.56% of all pregnancies. The prevalence of placenta previa in Indonesia in 2005 was 2.77% and 0.85% of them died (Kemenkes RI, 2007). The incidence of placenta previa in West Sumatra in 2010 was 106 based on hospital information system data (Handayani, 2013). Placenta previa is caused by the implantation of a low-lying blastocyst in the uterine cavity. Factors that influence the occurrence of placenta previa are increased maternal parity, increasing maternal age, enlargement of the size of the placenta due to multiple pregnancies, damage to the endometrium such as previous dilatation and curettage, history of previous cesarean section, scars on the uterus and myomectomy or endometritis. history of placenta previa, and smoking habits (Giordano et al., 2010). A woman named Mrs. K, 36 years old GIIPIA0 pregnant at term, came to the obstetric polyclinic with complaints of bleeding from the birth canal without pain. On examination, he was aware of compost mentis, blood pressure 120/80 mmHg. On obstetric examination, Leopold I found that the part in the fundus was the buttocks (round, not bouncy and felt soft), Leopold II on the left side of the mother had the back of the fetus (long like a board) and the right part of the mother had the extremities of the fetal body, Leopold III had the the lowest level of the fetus is the head (round, bouncy, and can be felt hard, singular), 28 cm TFU and FHR 140x/minute. On ultrasound examination, the results of placenta previa totalis which covered the birth canal, low levels of amniotic fluid and 1800 gram TBJ. The analysis that can be enforced in this patient is Mrs. K GIIPIA0 gestational age 30 weeks intrauterine single live fetus with placenta previa totalis and oligohydramnios. The management carried out was to make a referral to the Gayatri (delivery) room for a SC delivery with an obstetrician.