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Obstetric And Gynecology > ANTEPARTUM HAEMORRHAGE > Flashcards

ANTEPARTUM HAEMORRHAGE Flashcards

1
Q

What is the definition of antepartum haemorrhage (APH)?

A

APH is defined as bleeding from the genital tract after the 28th week of gestation until delivery.

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2
Q

Why is 28 weeks considered the landmark for APH in developing countries?

A

28 weeks is considered the landmark because it marks viability and the registration of stillbirths in developing countries.

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3
Q

List the primary causes of APH.

A

Causes include placenta praevia, abruptio placenta, local causes, vasa praevia, circumvallate placenta, and indeterminate haemorrhage.

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4
Q

What is placenta praevia?

A

Placenta praevia is when the placenta is wholly or partially located in the lower uterine segment.

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5
Q

How is placenta praevia classified?

A

Placenta praevia is classified into four types based on the extent of attachment to the internal os.

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6
Q

What are the differences between minor and major placenta praevia?

A

Types 1 & 2 are minor placenta praevia, and Types 3 & 4 are major placenta praevia.

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7
Q

What are the types of abnormal placentation?

A

Abnormal placentation includes placenta accreta, increta, and percreta.

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8
Q

List predisposing factors for placenta praevia.

A

Predisposing factors include advanced maternal age, increased parity, previous uterine surgery, and multiple pregnancies.

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9
Q

What are the classical symptoms of placenta praevia?

A

Symptoms include painless, bright red vaginal bleeding, recurrent bleeding, and torrential bleeding closer to term.

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10
Q

How is placenta praevia diagnosed?

A

Diagnosis involves ultrasound, MRI, high presenting part, and contraindicated vaginal examination.

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11
Q

What management strategies are used for placenta praevia?

A

Management includes conservative approaches like bed rest and surgery for major cases.

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12
Q

What are the complications of placenta praevia?

A

Complications include haemorrhage, anaemia, shock, and death.

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13
Q

Define abruptio placenta.

A

Abruptio placenta is the premature separation of a normally situated placenta before delivery.

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14
Q

What is Couvelaire uterus?

A

Couvelaire uterus is when bleeding occurs into the myometrium.

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15
Q

What are the primary causes of abruptio placenta?

A

The primary cause of abruptio placenta is unknown, but hypertension and trauma are significant contributors.

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16
Q

What are the risk factors for abruptio placenta?

A

Risk factors include advanced maternal age, parity, polyhydramnios, and rapid uterine decompression.

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17
Q

How is abruptio placenta diagnosed?

A

Diagnosis is based on painful uterine contractions with vaginal bleeding and absence of fetal heart rate.

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18
Q

What is the hallmark symptom of abruptio placenta?

A

The hallmark symptom is painful uterine contractions with vaginal bleeding in the third trimester.

19
Q

How is abruptio placenta managed?

A

Management includes conservative methods for mild cases and surgery for severe cases.

20
Q

What are the maternal complications of abruptio placenta?

A

Maternal complications include haemorrhage, shock, DIC, and maternal death.

21
Q

What are the fetal complications of abruptio placenta?

A

Fetal complications include hypoxia, anaemia, IUGR, and fetal death.

22
Q

Define vasa praevia.

A

Vasa praevia is bleeding from unprotected fetal vessels over the cervical opening.

23
Q

What is the incidence of vasa praevia?

A

Vasa praevia occurs in 1 in 5000 singleton deliveries.

24
Q

What diagnostic test is used for vasa praevia?

A

The APT test is used to diagnose vasa praevia.

25
Q

What is circumvallate placenta?

A

Circumvallate placenta is when fetal membranes wrap twice over the fetal side of the placenta.

26
Q

What complications can arise from circumvallate placenta?

A

Complications include placental abruption and thickening of the placental edge.

27
Q

What is indeterminate haemorrhage?

A

Indeterminate haemorrhage occurs when the cause is unknown.

28
Q

What local causes can lead to APH?

A

Local causes include cervical cancer, polyps, cervicitis, and condylomata acuminata.

29
Q

What is friable condylomata acuminata?

A

Friable condylomata acuminata are fragile growths caused by HPV.

30
Q

What are the degrees of placenta praevia?

A

Degrees of placenta praevia range from Type 1 (partial) to Type 4 (complete).

31
Q

What are the risk factors for cervical cancer as a cause of APH?

A

Risk factors for cervical cancer include HPV infection and smoking.

32
Q

How is gentle vaginal speculum examination important in APH?

A

Gentle vaginal speculum examination helps identify local causes of bleeding.

33
Q

What are the fetal risks associated with APH?

A

Fetal risks include hypoxia, anaemia, IUGR, and death.

34
Q

What are the maternal risks associated with APH?

A

Maternal risks include haemorrhage, shock, DIC, and renal failure.

35
Q

What is the role of ultrasound in APH diagnosis?

A

Ultrasound is crucial for diagnosing placenta praevia and abruptio placenta.

36
Q

When is MRI indicated for APH diagnosis?

A

MRI is indicated when ultrasound findings are inconclusive.

37
Q

What surgical interventions are used for APH management?

A

Surgical interventions include cesarean delivery for severe cases.

38
Q

Why is early involvement of haematology important in APH?

A

Early involvement of haematology is critical for managing coagulopathy in APH.

39
Q

How is blood transfusion used in managing APH?

A

Blood transfusion restores maternal blood volume and oxygenation.

40
Q

What is the role of corticosteroids in managing APH?

A

Corticosteroids enhance fetal lung maturity in preterm deliveries.

41
Q

What is the significance of advanced maternal age in APH?

A

Advanced maternal age increases the risk of APH and complications.

42
Q

How does smoking contribute to APH?

A

Smoking affects uteroplacental blood flow, increasing the risk of APH.

43
Q

What is the impact of polyhydramnios on APH?

A

Polyhydramnios can lead to uterine overdistension and abruptio placenta.

44
Q

What are the limitations of clinical assessment in abruptio placenta?

A

Clinical assessment in abruptio placenta may miss concealed haemorrhage.

Obstetric And Gynecology (27 decks)

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