G5P3A1 28 weeks pregnant with Moderate Degree Anemia e.c. Antepartum Haemorrhage ec Placenta Previa Totalis and Third Time Sectio Caesaria History

Abstract

Placenta previa is the placenta implanting in the lower uterine segment in such a way that it covers all or part of the internal uterine os. The risk factors for placenta previa are not known with certainty, but from several studies it has been reported that placenta previa occurs more frequently in pregnancies with high parity and at the age of over 30 years, multiple pregnancies, uterine defects, such as in mothers with uterine myomas or a history of sectio surgery. cesarean. A 29-year-old woman came with a chief complaint of bleeding from the birth canal since 2 weeks before entering the hospital and getting worse 2 days before entering the hospital. The blood that came out was fresh red, changed the pads 3-4 times, the bleeding was not accompanied by pain. Based on physical examination, vital signs were within normal limits. On obstetric examination, the height of the uterine fundus was 28 cm, a round soft lump was felt on the impression of the buttocks on Leopold I, a long flat part was felt on the right side on the back impression on Leopold II, a round hard bouncy terabit was the impression of the head on Leopold III, convergent (not yet entered PAP) on Leopold IV, fetal heart rate 140x/minute, estimated fetal weight 2,480 grams, his (-). Inspector examination found closed OUE, flux (+) active bleeding, fluorine (-). On supporting examinations in the form of ultrasonography, the results of the examination in the patient showed that the presentation of a live intrauterine-uterine double-headed fetus, BPD-1 28w2d: 933 gr, BPD-228w2d: 1,311 gr, sufficient amniotic fluid, clear zone, placenta previa totalis covering the entire OUI. In this case the pregnancy was terminated with the use of emergency cesarean section.

Key words: placenta previa, multiple pregnancy, antepartum haemorrhage