Modifiable factor Women who smoke

Non-modifiable factors Age of gravida: above 35y/o Multiparaty Previous Cesarean section

Pregnancy

Uterine Atrophy

Abnormal vascularization of endometrium

Low Placental implantation (2nd & 3rd trimester) Implantation in low uterine

Placenta Previa

Total/complete (PP) Early (20-28weeks) Large amount of bleeding

Partial (PP) Between total & marginal

Marginal and Low Lying (PP) Late (37-40weeks)/ in labor Less bleeding

Cervical Dilation

Cover Internal os of Cervix

Disrupted Placental attachment

Uterine Contraction

Malpresentation of fetus

Decreased uterine blood flow

Bright red vaginal bleeding

Blood loss

Decreased fetal oxygen supply

Decreased bood volume

Fetal distress IUGR

Hypovolemia Preterm Labor Pallor Decreased kidney perfusion Decreased urine output Compensatory mechanism Hypotension

Congenital Anomalies

Cold clammy skin

Decreased capillary refill time

Tachycardia

Tachypnea