Abruption Flashcards
Management of abruption ?
TOP
VD> CS
Labour will be fast due to tissue thromboplastin.
Entire process within 3 hrs.
Next step if abruption rivealed ?
ARM
Therapeutic(IOL due to release of PG) & diagnostic (blood stained liquor)
CS dor abruption Intra op findingv
Couvelaire uterus
Aka uteroplacental apoplexy.
Seen in concealed abruption.
Bleeding into myometrium.
Fetal reduction?
Reduce multifetal to twin
Ideal ➡️ 10-13 weeks by intracardiac Kcl inj.
Super fecundation k superfetation
Super fecundation – 2 ova same cycle
Super fetation – 2 ova diff cycle
Monoamniotic Complication & Management
Cord entanglemnt at >/ =32 weeks
Elective cs at 32 weeks
MC presentstion of twins v
Depends on 1st twin lie
Vx vx
2nd MC : Vx breach
If first twin Long / vx ➡️ Vag delivery
1st Vx & 2nd transverse lie then delivery?
Vaginal delivery
Then IPV (under anaesthesia)
Callled breach extraction
Bcz aftr anesthesia no cx manually extract the baby
IPV - Not done in scarred uterus – C/iin prev cs
Uterine Dehisence
If all the layers of myometrium in scsr given away but serosa intact
If serosa also given away then –> rupture.
Most charecteristic sign of uterine rupture ?
Loss of station
IoL in prev Cs ?
NOT C/I but not preferable
Even if done use oxytocin
Preferrd is spontaneous.
Can u do augmentation in prev Cs?
Not absolute C/I
Preferably NO
If done ,with oxytocin.
Aug with continuos FHR monitoring.
Ecv if prev cs?
Relative C/I
IPV ; absolute C/I
Ideal time gap for conception : 18 months
Min 6 m
