A patient at 34 weeks with placenta previa has ongoing vaginal bleeding but normal fetal heart rate and no labor. What is the priority nursing action?

A patient at 34 weeks with placenta previa has ongoing vaginal bleeding but normal fetal heart rate and no labor. What is the priority nursing action?

• A. Monitor the amount of vaginal blood loss.
• B. Prepare for cesarean delivery immediately.
• C. Place the patient in Trendelenburg position
• D. Encourage strenuous activity.

Answer: (C)

The key idea is to stabilize the mother and protect perfusion during antepartum hemorrhage from placenta previa. When bleeding is ongoing, the most urgent action is to support circulation so vital organs, including the uterus and fetus, continue to receive blood flow while definitive management is arranged. Placing the patient in Trendelenburg (head lower than the feet) is described as a rapid way to increase venous return to the heart in a hypovolemic state. By shifting blood toward the central circulation, this position can help raise blood pressure and improve overall perfusion temporarily while you start IV fluids or blood products and prepare for possible cesarean delivery. It buys time to stabilize the patient and assess both maternal and fetal status. After stabilization, the usual teaching emphasizes repositioning to optimize uteroplacental perfusion—often a left lateral position—to relieve uterine compression and improve blood flow to the placenta. Throughout, continuous fetal monitoring and prompt obstetric consultation are essential.

The key idea is to stabilize the mother and protect perfusion during antepartum hemorrhage from placenta previa. When bleeding is ongoing, the most urgent action is to support circulation so vital organs, including the uterus and fetus, continue to receive blood flow while definitive management is arranged.

Placing the patient in Trendelenburg (head lower than the feet) is described as a rapid way to increase venous return to the heart in a hypovolemic state. By shifting blood toward the central circulation, this position can help raise blood pressure and improve overall perfusion temporarily while you start IV fluids or blood products and prepare for possible cesarean delivery. It buys time to stabilize the patient and assess both maternal and fetal status.

After stabilization, the usual teaching emphasizes repositioning to optimize uteroplacental perfusion—often a left lateral position—to relieve uterine compression and improve blood flow to the placenta. Throughout, continuous fetal monitoring and prompt obstetric consultation are essential.