Define Placenta previa .How will you manage a case of Placenta Previa .J 07

DEFINITION: When the placenta is implanted partially or completely over the lower uterine segment
(over and adjacent to the internal os) it is called placenta previa.

Management of Placenta Praevia :
Clinical Features ;  
Symptoms :
.placenta -parevia
1Sudden Onset 
2.Painless 
3.Apparently causeless  & recurrent 
4.Vaginal bleeding 

Signs;
General Examination :
1. Anaemia 
2.Tachycardia   & hypotension 
3.Cold Clammy skin
4. Respiration Rapid 

Per vaginal Examination :
1Th e size of the uterus is proportionate of gestation 
2.Th e uterus feels relaxed, soft and elastic 
3.Persistence of malpresentation
4. Th e head is floating
5. Fetal heart sound is usually present

Vaginal examination:
On inspection ,the blood is bright red 

  Investigation :
Blood  T.C D.C  ESR  HB% 
blood grouping 
Urine for R/M/E 
USG to confrim diagnosis 
TVS  -Transvaginal

Treatment :
A. General Treatment : 
1.Nothing by mouth 
2.Wide Brow I/V canula & I/v Fluid is tobe started  normal saline 
3.Blood should be taken for group ,cross matching &  transfusion 
4.Catheterization 
5.Monitoring 
B.Obstetrics Treatment :
1.Caesarean Section