When the placenta is implanted completely over the lower uterine segment, it is called......placenta previa?

Appeared in: IGIMS Staff Nurse - 2018

Explanation

Placenta previa is a condition where the placenta implants in the lower part of the uterus.
The question describes a scenario where the placenta is implanted 'completely over the lower uterine segment,' which means it fully covers the internal cervical os.
This specific type is termed Central Placenta Previa or Complete Placenta Previa.
It is the most severe form of placenta previa and carries the highest risk of hemorrhage.

Option B: Marginal placenta previa is when the edge of the placenta is at the margin of the internal cervical os but does not cover it.
Option C: Partial placenta previa is when the placenta covers only a part of the internal cervical os, not the entire opening. The term 'Partial central' is not a standard classification.
Option D: 'Side lying' is not a recognized medical term for the classification of placenta previa. It describes a body position.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Placenta Previa as background academic context rather than a clinical decision trigger.
A diagnosis of central (complete) placenta previa mandates a planned Cesarean delivery, typically scheduled for 36-37 weeks' gestation, to avoid the risks of labor and catastrophic hemorrhage.
Nursing care for a patient with placenta previa involves strict pelvic rest (no vaginal exams, no intercourse), continuous fetal monitoring if bleeding is active, and maintaining IV access for potential fluid and blood product resuscitation.
The hallmark sign is painless, bright-red vaginal bleeding. Nurses must be vigilant in assessing for bleeding and notifying the provider immediately, as even a small amount can be a precursor to a major hemorrhage.

How to Approach the Question

First, identify the core concept of the question, which is the classification of placenta previa.
The key phrase in the stem is 'implanted completely over the lower uterine segment.' This is the definition of a specific type of placenta previa.
Recall the different classifications of placenta previa: low-lying, marginal, partial, and complete (or central).
Match the definition provided in the question to the correct classification.
Eliminate the incorrect options. 'Marginal' and 'Partial' describe incomplete coverage. 'Side lying' is not a term used for placental classification.
Select 'Central' as it is synonymous with 'Complete' placenta previa, where the placenta fully covers the internal cervical os.

Concept Tested & Keywords

Concept Tested: Classification of Placenta Previa
Stem keywords: placenta, implanted completely, lower uterine segment, placenta previa
Lead-in keywords: it is called

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E6 Obstetrics Williams p. 69-94

Practise the full IGIMS Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.