Case Report: Placenta Previa Totalis With Fetal Distress and Stage III Hemorrhagic Shock in a 34-Year-Old Woman
DOI:
https://doi.org/10.53089/medula.v15i3.1588Keywords:
Antepartum hemorrhage, fetal distress, placenta previa totalisAbstract
Placenta previa is defined as a placenta implanted in the lower uterine segment (LUS), partially or completely covering the internal cervical os (ICO) after 20 weeks of gestation. The clinical manifestations of placenta previa are characterized by painless vaginal bleeding, which may lead to maternal and fetal emergencies if not properly managed. We report a case of a 34 years old woman G3P1A1 at 34 weeks of gestation, presenting with painless vaginal bleeding. The patient had a risk factor of previous abortion managed with curettage. Data were obtained through medical history, general physical examination, obstetric assessment, ultrasonography, and both pharmacological and non‑pharmacological management. Examination revealed approximately 1700 mL of blood loss, anemic conjunctiva, pale lips, accompanied by signs of shock and fetal distress, with hemoglobin level of 9.3 g/dL. Ultrasonography demonstrated total placenta previa extending to the anterior right corpus. The diagnosis was established as gravida 3 para 1 abortus 1 at 34 weeks of gestation with grade 3 hemorrhagic shock due to recurrent antepartum hemorrhage caused by total placenta previa, with a live singleton fetus in cephalic presentation and fetal distress. Management included stabilization of shock and maternal condition, followed by active intervention through emergency cesarean section, chosen to reduce maternal and fetal morbidity and mortality.
Keywords : Antepartum hemorrhage, Fetal distress, placenta previa totalis,
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