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Reproductive > Antepartum Haemorrhage > Flashcards

Antepartum Haemorrhage Flashcards

1
Q

What is antepartum haemorrhage?

A

Bleeding in late pregnancy after 24 weeks.

It is a medical emergency.

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2
Q

What are the 2 most common causes of antepartum haemorrhage?

A

Placental abruption

Placenta praevia

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3
Q

What is a vasa praevia?

A

Where foetal circulation is in contact with membranes.

Rare but serious.

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4
Q

When should uterine rupture be considered as the cause of APH?

A

Previous C-section

Previous uterine surgery

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5
Q

What is placental abruption?

A

A sudden of a normally implanted placenta.

May be partial or total.

Make up 40% of all APHs.

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6
Q

How does placental abruption present?

A

Severe continuous abdominal pain
Bleeding (although not always)

Can be cause of maternal collapse or preterm labour.

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7
Q

What is Kleihauer test?

A

A test used to determine amount of blood lost.

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8
Q

How is placental abruption treated?

A

Urgent C-section

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9
Q

What may follow placental abruption?

A

Hypovolaemic shock
Anaemia
PPH

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10
Q

What is placenta praevia?

A

A low-lying placenta, this is directly covering the cervical os.

This prevents the baby exiting the uterus.

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11
Q

How does placenta praevia present?

A

As the cervix opens, the placenta becomes disturbed, producing lots of bleeding.

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12
Q

What is placenta accreta?

A

A placenta growing into the wall of the uterus.

It is morbidly adherent.

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13
Q

How should placenta accreta be investigated?

A

Perform MRI

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14
Q

How does the uterus feel in placenta praevia?

A

Soft and tender.

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15
Q

Should a vaginal exam be performed in placenta praevia?

A

No, this may worsen the situation.

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16
Q

What is given to prevent neural tube defects in babies born before 32 weeks?

A

Magnesium sulfate

17
Q

What is given if the mother is rhesus negative?

A

Anti-D

18
Q

How is placenta accreta treated?

A

Prophylactic internal iliac artery balloon.

19
Q

How does uterine rupture present?

A 
Severe abdominal pain (despite epidural anaesthesia)
Shoulder-tip pain
Maternal collapse
Post-vaginal bleeding
Foetal compromise
Cessation of contractions
20
Q

What reduces risk of PPH?

A

Active management during the 3rd stage of labour.

21
Q

Why should ergometrine be avoided in hypertensive?CVD patients?

A

It causes a significant rise in BP.

22
Q

How is APH treated?

A

Kleihauer test
Anti-D
Steroids (to reduce risk to baby)

Reproductive (28 decks)

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