| Course | NU684 Obstetrical Care |
|---|---|
| Unit | Unit 7 |
| Paper type | Management plan |
| Length | About 930 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU684 Unit 7
Vessels Over the Cervix: A Unit 7 Management Plan for Vasa Previa Found at Twenty-Four Weeks
[Student Name]
Purdue University Global
NU684: Obstetrical Care
Unit 7 Management Plan
[Instructor Name]
[Date]
The patient and family are composite and illustrative; the sources cited are real.
The Diagnosis
Ms. Varnum is gravida 1 at 24 weeks 3 days, pregnant after one cycle of in vitro fertilization. Her 20-week anatomy scan showed a low-lying placenta and a velamentous cord insertion, where the cord attaches to the membranes rather than to the placenta. Both are risk factors for vasa previa, and the follow-up transvaginal scan with color Doppler confirmed unprotected fetal vessels running across the internal opening of the cervix, with a fetal heart-rate waveform in them.
Vasa previa means that fetal vessels, not protected by placental tissue or the cord's jelly, lie in the membranes over or near the cervix. If the membranes rupture or the cervix dilates, those vessels can tear, and the baby, whose total blood volume at term is only about 250 to 300 milliliters, can bleed to death within minutes.
Why Prenatal Diagnosis Matters
In a multicenter series, 97 percent of babies with vasa previa diagnosed before birth survived, compared with 44 percent when the condition was not known until delivery (Oyelese et al., 2004). Prenatal diagnosis allows delivery by cesarean before labor or membrane rupture. The Society for Maternal-Fetal Medicine notes that about 28 percent of prenatally diagnosed cases still end in an emergency preterm delivery, which is why the plan prepares for an unscheduled birth as carefully as for the planned one (Sinkey et al., 2015).
Her baby's best protection is that everyone now knows the vessels are there.
The Management Schedule
The Society for Maternal-Fetal Medicine consult recommends antenatal corticosteroids between 28 and 32 weeks, consideration of hospitalization at 30 to 34 weeks, and scheduled delivery at 34 to 37 weeks (Sinkey et al., 2015). The plan applies that guidance to her.
24 to 30 weeks. Visits every two weeks, with transvaginal ultrasound every two to four weeks to recheck the vessels and measure the cervix, since a shortening cervix would bring admission forward. She is asked to avoid intercourse and anything placed in the vagina, and to avoid heavy lifting.
28 to 32 weeks. A course of betamethasone, two injections 24 hours apart, at 30 weeks. ACOG supports a single course of antenatal corticosteroids for those at risk of delivery within seven days between 24 and 34 weeks, and this plan times the course to the period of highest risk before the planned admission (American College of Obstetricians and Gynecologists [ACOG], 2017).
Admission from 32 weeks. Ms. Varnum lives 55 minutes from the tertiary hospital, and travel time in an emergency counts heavily. She is admitted at 32 weeks to the antepartum unit, with daily fetal heart rate monitoring and a bed close to the operating room. Had she lived ten minutes away with a short labor-free history and a long cervix, outpatient management would have been discussed.
Delivery at 34 to 35 weeks. A planned cesarean is scheduled at 34 weeks 4 days, within the recommended window, balancing the risk of membrane rupture against the risks of prematurity.
The Emergency Plan
The plan is written into her chart and posted at the nurses' station. Any vaginal bleeding, rupture of membranes or regular contractions triggers an immediate call to the obstetric team and preparation for emergency cesarean. Because bleeding in vasa previa is fetal blood, not maternal, a small bleed can be catastrophic for the baby, and the team does not wait to observe it. O-negative blood for the newborn is available in the operating room, and the neonatal team is told about the diagnosis in advance so they can be ready to transfuse.
Explaining the Plan to Her
Ms. Varnum's first question was whether she had caused this by choosing in vitro fertilization. She was told that assisted conception is associated with a higher chance of vasa previa, that nothing she did or could have done would have prevented it, and that the scan finding it early was the best possible outcome of that association. Her second question was whether she could avoid six weeks in hospital. The clinician explained that admission is a judgment, not a rule, and that her distance from the hospital was the main reason for it.
The Cesarean
The surgical team reviews the ultrasound maps of the vessels before the operation so the uterine incision avoids them. The neonatal team attends. Cord clamping is immediate rather than delayed if the vessels are torn during delivery.
Supporting the Family
Six weeks in the hospital is a burden. Ms. Varnum's employer is informed, with her permission, and a social worker reviews leave and insurance. Her partner is encouraged to stay overnight when possible. The NICU team meets the couple at 33 weeks to explain what a baby born at 34 weeks usually needs. She is screened for anxiety and depression on admission and every two weeks.
Documentation
The chart records the diagnostic scan, the steroid dates, the admission, the emergency protocol, the scheduled delivery date and the neonatal team's notification.
Conclusion
Ms. Varnum's vasa previa was found before it could cause harm, which turns a condition that kills many babies into one most survive. The plan follows the Society for Maternal-Fetal Medicine schedule, with steroids at 30 weeks, admission at 32 weeks because of her distance from the hospital and a planned cesarean at 34 weeks, and prepares every team for an emergency in between.
References
American College of Obstetricians and Gynecologists. (2017). Committee opinion no. 713: Antenatal corticosteroid therapy for fetal maturation. Obstetrics & Gynecology, 130(2), e102-e109. https://doi.org/10.1097/AOG.0000000000002237
Oyelese, Y., Catanzarite, V., Prefumo, F., Lashley, S., Schachter, M., Tovbin, Y., Goldstein, V., & Smulian, J. C. (2004). Vasa previa: The impact of prenatal diagnosis on outcomes. Obstetrics & Gynecology, 103(5), 937-942. https://doi.org/10.1097/01.AOG.0000123245.48645.98
Sinkey, R. G., Odibo, A. O., & Dashe, J. S. (2015). #37: Diagnosis and management of vasa previa. American Journal of Obstetrics and Gynecology, 213(5), 615-619. https://doi.org/10.1016/j.ajog.2015.08.031
Reading the NU 684 Unit 7 instructions
The seventh unit commonly asks for a management plan for a bleeding risk or placental condition in late pregnancy, such as placenta previa, vasa previa or a low-lying placenta. Prompts typically want the diagnosis and how it was made, the risks to mother and baby, a schedule for surveillance, corticosteroids, admission and delivery, an emergency plan and support for the family. Instructors reward plans that follow a named guideline schedule and adapt it to the patient's circumstances, such as distance from the hospital. Exact gestational ages are expected for each step. Sources usually include the Society for Maternal-Fetal Medicine consult series or ACOG guidance on the condition, an outcome study that explains why prenatal diagnosis matters, and the committee opinion on antenatal corticosteroids. The emergency protocol should be written clearly enough for staff to follow.
Inside the NU684 Unit 7 example
The Varnum plan describes the two findings that led to the diagnostic scan and explains what vasa previa is, including how little blood a fetus can lose. A section on prenatal diagnosis uses Oyelese and colleagues' survival figures and the Society for Maternal-Fetal Medicine's emergency delivery rate, under a highlighted line about everyone knowing the vessels are there, with a margin note on the survival data. The schedule follows Sinkey and colleagues' consult, step by step: surveillance scans, steroids at 30 weeks with ACOG's guidance, admission at 32 weeks justified by her travel time, and cesarean at 34 weeks 4 days. Fetal origin of any bleeding is the emergency plan's key point, and a second margin note marks it. Next, a passage on explaining the plan addresses her questions about in vitro fertilization and admission. The cesarean, family support and documentation close the plan.
NU684 Unit 7 rubric: what earns full points
Management plans for this unit are scored on accurate diagnosis, a guideline-based schedule with exact timing, individual adaptation, emergency preparedness, family support and documentation. Diagnosis credit includes how the condition was confirmed. Schedule marks require each step at the gestational age the guidance recommends, with the source cited. Adaptation earns credit when the plan explains decisions such as admission by the patient's distance, history or cervical length. Emergency preparedness is weighted heavily: graders look for a written protocol, immediate response to any bleeding or membrane rupture, and neonatal readiness. Supporting a long hospital stay, including mental health screening and social work, distinguishes strong plans. The surgical plan should avoid the vessels and involve the neonatal team. Clear headings and APA references for the consult series, the outcome study and the corticosteroid opinion complete the rubric.
NU684 Unit 7 help from the desk
Plans lose marks most often when they describe the condition accurately but give no gestational ages for steroids, admission or delivery. Another frequent error is planning a trial of labor or delaying delivery to 39 weeks, which is unsafe with vasa previa. Some plans treat a small bleed as something to observe, missing that the blood is fetal. Others admit every patient without explaining the decision, or send home a patient who lives far from the hospital without a travel plan. Forgetting neonatal readiness, including blood for the newborn, is a common gap. Start by writing the three dates the guidance sets, then decide whether the patient's circumstances move any of them. Draft the emergency protocol in plain steps. Send the case and your plan instructions, and a management plan can be built from that schedule.
Get an NU684 Unit 7 example written to your instructions
Send the case, the ultrasound report and the plan instructions with the rubric. A custom plan sets admission and steroid timing, the delivery window and what the patient must do if bleeding starts. It arrives within 24-48h, free the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU684 Unit 7 questions, answered
What is vasa previa?
Fetal blood vessels running across or near the cervix, unprotected by placenta or cord. If they rupture, the baby can lose blood quickly. Prenatal diagnosis greatly improves survival.
When is a pregnancy with vasa previa delivered?
Usually by planned cesarean between 34 and 37 weeks. A plan should state the timing and the reasons.
Does vasa previa require hospital admission?
Some centers admit around 30 to 34 weeks; others manage selected patients at home. A plan should discuss the factors in that decision.
Where can I find a free NU684 Unit 7 sample paper?
The complete NU684 Unit 7 management plan sits on this page. It manages vasa previa found at 24 weeks in a composite patient, with steroids at 30 weeks, admission at 32 weeks and a planned cesarean at 34 weeks, plus an emergency protocol.
Why is any bleeding treated as an emergency in the NU684 Unit 7 plan?
In vasa previa the bleeding comes from fetal vessels, and a baby at term has only about 250 to 300 milliliters of blood. Even a small loss can be life-threatening, so the team prepares for immediate cesarean.