Ante and post-partum bleeding Flashcards
Describes the situation where the placenta lies in the lower uterine segment in front of the presenting part
Placenta praevia
Predisposing factors towards placenta praevia (3)
Multips
multiple pregnancy
previous c-section
Presentation of placenta praevia (2)
painless blood loss
high presenting part or abnormal lie
Premature (before delivery) separation of the placenta
Placental abruption
Diagnostic features of abruption
Vaginal bleeding which may be “concealed”
Abdominal pain
Tense, tender, “woody” uterus
Fetal distress on CTG
What may be a catastrophic complication of abruption?
Disseminated intravascular coagulopathy
Describes the situation where foetal vessels lie in the membranes and over the cervical os
vasa praevia
The four “T”s which are the most common causes of primary post-partum haemorrhage
Tone- uterine atony
Trauma
Tissue- retained placenta
Thrombin- coagulopathy
Two common causes of secondary post-partum haemorrhage
Endometritis
Retained products of conception
Management of uterine atony
Bimanual uterine compression
Oxytocin
Ergometrine
What is placenta accreta?
Condition where the placenta implants directly into the myometrium
Risk factors for placenta accreta? (3)
Past C-sections
Pelvic inflammatory disease
Asherman syndrome (uterine adhesions)
Management of placenta accreta?
Often hysterectomy
What is primary post-partum haemorrhage?
Bleeding in excess of 500mls/24 hours
How is placenta praevia graded?
According to how much of the cervical os is covered by the placenta
