Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction and sexual health > Antepartum haemorrhage > Flashcards

Antepartum haemorrhage Flashcards

1
Q

When does bleeding in early pregnancy occur

A

<24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does bleeding in late pregnancy occur

A

> =24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At which week of gestation is the foetus said to be viable

A

24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define antepartum haemorrhage APH

A

bleeding from the genital tract after 24/40 and before the end of the second stage of labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aetiology of APH

A 
Placental: previa, abruption 
Uterine: rupture 
Indeterminate 
Foetal: vasa previa 
Local causes: cervical, vaginal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How much blood is seen in spotting

A

streaks, stains or upon wiping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How much blood is lost in minor APH

A

<50 ml

settled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How much blood is lost in major APH

A

50-1000ml

NO shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much blood is lost in a massive APH

A

> 1000ml

+/or shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is placental abruption

A

separation of a normally implanted placenta - partially/totally before the birth of the foetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Placental abruption needs imaging to confirm the diagnosis, true or false

A

FALSE

Placental abruption is a clinical diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the pathophysiology behind placental abruption

A

vasospasm followed by arteriole rupture into the decidua
blood escapes into amniotic sac or further under the placenta into the myometrium
causes tonic contraction
interrupts placental circulation –> hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Couvelaire uterus and in which condition is it seen

A

“blue” uterus from extravasation of blood into uterus

seen in placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List risk factors for placental abruption

A 
HTN/PET 
smoking 
trauma 
cocaine / amphetamine 
thrombophilias 
DM / renal disease 
polyhydramnios 
multiple pregnancy 
PPROM 
abnormal placenta 
previous placental abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of placental abruption

A 
Continuous severe abdominal pain 
backache if placenta lies posteriorly
Maternal collapse 
Bleeding (may be concealed)
Pre term labour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are signs of placental abruption

A 
Distressed patient 
Appearance of patient may not match up to how much blood they have lost 
Normal / LFD uterus 
Tender uterus 
Woody hard uterus 
Difficult to identify foetal parts 
Foetal HR - bradycardia / absent 
CTG shows irritable uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of placental abruption

A 
RESUSCITATE mother 
2 large bore IV access 
FBC, clotting, U+E, LFT, crossmatch 4-6 units
Kleihauer - Rh -ve 
IV fluids 
Catheterise
assess foetus and foetal HR 
category 1 c-section
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In which groups of patient should care be taken in administering IV fluids

A

Those with pre eclampsia or heart conditions –> pulmonary oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are maternal complications of placental abruption

A 
infection 
hypovolaemic shock 
anaemia
PPH 
renal failure - renal tubular necrosis 
DIC 
VTE 
PTSD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List foetal complications of placental abruption

A

IUD
hypoxia
pre term delivery
SGA + FGR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define placenta previa

A

placenta lies directly over internal cervical os

22
Q

Define low lying placenta

A

> 16/40

placental edge is <20mm from internal cervical os on TVUSS/TAUSS

23
Q

List risk factors for developing placenta previa

A 
previous c-section 
previous placenta previa 
smoking 
assisted conception treatment 
previous TOP 
multiparity 
age >40 
damaged endometrium
24
Q

Is placenta previa screened for and if so what is the process

A

Yes
screened at 20 week anomaly scan
If abnormal, repeat scan at 32 + 36 weeks

25
Q

Which method is better for diagnosing placenta previa, TVUSS or TAUSS

A

TVUSS

26
Q

If placenta accreta is suspected, what imaging should be done

A

MRI

27
Q

Symptoms of placenta previa

A

painless bleeding > 24 weeks
unprovoked or post-coital
patients condition directly proportional to amount of bleeding seen

28
Q

Signs of placenta previa

A

uterus is soft and non-tender
presenting part high
malpresentation
Normal CTG

29
Q

It is ok to perform a digital PV/PR exam for placenta previa, true or false

A

FALSE!

This should not be done until you have excluded placenta previa as a diagnosis

30
Q

management of placenta previa in stable mother

A 
Resuscitate mother 
assess foetus 
anti-D if Rh-
prevent and treat anaemia 
avoid sex 
antenatal steroids 
magnesium sulphate 24-32 weeks neuroprotection
31
Q

management of placenta previa in unstable mother

A 
resuscitate mother 
assess foetus 
2 large bore IV access 
FBC, clotting, LFT, U+E, crossmatch 4-6 units 
Kleihauer - Rh- --> anti D
major haemorrhage protocol 
IV fluids/blood transfusion
32
Q

in placenta previa, when should a symptomatic mother consider delivery

A

34-36+6 weeks

33
Q

in placenta previa, when should an asymptomatic mother consider delivery

A

36-37 weeks

34
Q

in placenta previa, what is the indication for a c-section

A

the placenta directly covers the internal cervical os

or is < 2 cm from os

35
Q

in placenta previa, what is the indication for a vaginal delivery

A

placenta >2cm from internal cervical os and there is no malpresentation

36
Q

Define placenta accreta

A

morbidly abnormal adherent placenta to the uterine wall

37
Q

What increases the risk of placenta accreta

A

multiple c-sections

placenta previa

38
Q

symptoms of placenta accreta

A

bleeding

PPH

39
Q

define placenta percreta

A

penetrating uterus to bladder

40
Q

define placenta increta

A

invading myometrium

41
Q

what is the management for placenta accreta

A

prophylactic iliac artery balloon by IR

caesarean hysterectomy

42
Q

Define uterine rupture

A

full thickness (including serosa) opening of the uterus

43
Q

what increases the risk of uterine rupture

A

previous c-section or uterine surgery
multiparity
use of syntocin
obstructed labour

44
Q

symptoms of uterine rupture

A

severe abdominal pain
shoulder tip pain
maternal collapse
PV bleeding

45
Q

signs of uterine rupture

A 
loss of uterine contractions in labour
acute abdomen 
presenting part rises 
peritonism 
foetal distress 
IUD
46
Q

Management of uterine rupture

A 
Resuscitate 
2 large bore IV access 
FBC, U+E, LFT, crossmatch 4-6 units, clotting
Kleihauer - Rh- --> anti D
major haemorrhage protocol 
IV fluids / blood transfusion
47
Q

Define vasa previa

A

rupture of unprotected foetal vessels that traverse the membrane below the presenting part but over the internal cervical os during labour or ARM/amniotomy

48
Q

there is screening for vasa previa, true or false

A

FALSE

49
Q

how is vasa previa diagnosed

A

TAUSS + TVUSS

50
Q

risk factors for vasa previa

A

bi-lobed/succenturiate placenta
low lying placenta in 2nd trimester
multiple pregnancy
IVF

51
Q

Management of vasa previa

A

antenatal steroids 32-34 weeks
elective c-section before labour
emegency c-section if diagnosed during labour
placenta for histology

Reproduction and sexual health (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions