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Obstetrics > Antepartum Haemorrhage > Flashcards

Antepartum Haemorrhage Flashcards

1
Q

What is the definition of an antepartum haemorrhage?

A

ANY bleeding from the genital tract anytime past 22 weeks

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2
Q

What are the 4 types of antepartum bleeding?

A

Spotting
Minor
Major
Massive

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3
Q

Define minor antepartum haemorrhage?

A

<50mls

Typically settles on it’s own

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4
Q

Define major anterpartum haemorrhage?

A

50 - 1000mls

WITHOUT SIGNS OF SHOCK

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5
Q

Define massive antepartum haemorrhage?

A

> 1000mls

OR

Any blood loss with signs of shock

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6
Q

How can causes of antepartum haemorrhage be split?

A

MATERNAL

  • Local
  • Systemic

FOETAL

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7
Q

What 3 structures can bleed and be the local maternal causes of antepartum haemorrhage?

A

Placenta

Uterine

Cervical

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8
Q

What are placental causes of bleeding?

A

Placental abruption
Placenta praevia
Placenta accreta

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9
Q

What is placenta accreta and what commonly causes it?

A

Placenta implants in myometrium

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10
Q

What are the other malimplantation of the placenta deformities?

A

Placenta increta (almost at serosa)

Placenta percreta (all the way through)

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11
Q

What may cause bleeding from the uterus?

A

Asherman’s syndrome

Fibroids

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12
Q

What is asherman’s syndrome and what causes it?

A

Fibrotic cords that traverse the uterus and cause stricture

Typically caused by multiple surgery

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13
Q

What may be cervical causes of bleeding?

A

Polyps

Erosions

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14
Q

What are the systemic maternal causes of bleeding?

A

Thrombocytopenia

  • ITP
  • DIC

Von willebrands

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15
Q

What is a foetal cause of bleeding?

A

Vasa previa

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16
Q

What is vasa previa?

A

Umbillical cord compressed as lies over birth canal when foetus descends

17
Q

Treatment of vasa previa?

A

Requires urgent C-section

18
Q

What are the risk factors of placenta praevia?

A

Multiparity
Smoking
Previous c section

19
Q

What is the grading of placenta praevia?

A

Low lying - edge of placenta between 2-3.5 cm from os
Marginal - edge within 2cm of os
Partial - doesn’t completely occlude os but covers some of it
Complete - os completely occluded

20
Q

Treatment of low lying and marginal placenta praevia?

A

Should be a normal delivery but offered c section

21
Q

Treatment of partial and complete placenta praevia?

A

c section

22
Q

What tests should be done for antepartum haemorrhage?

A

Placental abruption must be excluded first

USS

Abdo exam

CTG

23
Q

What may be seen on abdominal exam in placental abruption?

A

Woody abdomen

24
Q

What examination must not be done in antepartum haemorrhage?

A

Vaginal exam

Obstetrics (15 decks)

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