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ENRP > Antepartum Hemorrhage > Flashcards

Antepartum Hemorrhage Flashcards

1
Q

1 unit of PRCBs will have what effect on the Hgb and the Hct?

A

Hgb goes up by 1

Hct goes up by 3%

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2
Q

1 unit of platelets will have what effect on the platelet levels?

A

Platelets will increase by 5-10,000

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3
Q

1 unit of Fresh Frozen Plasma will have what effect on the Fibrinogen?

A

Fibrinogen will increase by 10

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4
Q

1 unit of Crypercipitate will have what effect on the Fibrinogen?

A

Fibrinogen will increase by 10

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5
Q

Antepartum Hemorrhage is defined as bleeding when?

A

During pregnancy after 20 weeks gestation

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6
Q

What is the most common type of abnormal placentation?

A

Placenta Previa

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7
Q

What is Placenta Previa?

A

Implantation of the placenta over the cervical os

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8
Q

Until you can rule out Placenta Previa, what should you NOT do?

A

Digital exam

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9
Q

Signs of Placenta Previa?

A

PAINLESS vaginal bleeding

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10
Q

If a pregnant woman presents with painless vaginal bleeding, what should you consider is likely?

A

Placenta Previa

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11
Q

Marginal Placenta Previa

A

Placenta does NOT cover the cervical os

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12
Q

Partial Placenta Previa

A

Partial occlusion of the cervical os by the placenta

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13
Q

Complete Placenta Previa

A

Cervical os is completely covered by the placenta

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14
Q

What is the most serious type of Placenta Previa that is associated with more blood loss?

A

Complete Placenta Previa

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15
Q

How can Placenta Previa be diagnosed and usually when?

A

Ultrasound around 30 weeks

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16
Q

Most causes of Placenta Previa will spontaneously resolve with placental migration. When should you deliver and how if not?

A

36-37 weeks via C-section

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17
Q

If the placenta is attached to the superficial lining of the myometrium?

A

Placenta Accreta

18
Q

If the placenta is invading the myometrium?

A

Placenta Increta

19
Q

If the placenta has invaded through the myometrium to the uterine serosa?

A

Placenta Percreta

20
Q

What is the most common cause of 3rd trimester bleeding?

A

Placental Abruption

21
Q

What is Placental Abruption?

A

Premature separation of the normally implanted placenta

22
Q

What are the signs of Placental Abruption?

A

PAINFUL bleeding, uterine tenderness/hyperactivity and fetal distress

23
Q

A pregnant woman presents with painful bleeding, uterine tenderness and fetal distress, what is considered likely?

A

Placental Abruption

24
Q

What are the 2 most common risk factors for Placental Abruption?

A

Maternal HTN

External trauma to the mother

25
Q

If Placental Abruption is present, what often ensues?

A

Rapid delivery - either vaginally or C-section depending on patient stability

26
Q

What are 2 adverse effects that can occur with Placental Abruption?

A

DIC

Couvelaire Uterus

27
Q

DIC often occurs with Placental Abruption. What is Couvelaire Uterus?

A

Red/purple uterine serosa from the extravasation of blood into uterus

28
Q

What is Uterine Rupture?

A

Complete separation of the uterine musculature through all of its layers

29
Q

What is a common risk factor for Uterine Rupture?

A

Prior uterine incision

30
Q

What are the signs of Uterine Rupture for the mother and baby?

A
  • Sudden, intense abdominal pain +/- bleeding
  • Abnormal FHR or cessation
  • Regression of presenting part
31
Q

If the pregnant mother has sudden, intense abdominal pain and then there is abnormal FHR or cessation of it with the regression of the fetal presenting part, what should you consider as likely?

A

Uterine Rupture

32
Q

With Uterine Rupture, what may be felt on abdominal exam?

A

Fetal parts

= complete separation of uterine musculature through all the layers

33
Q

What is the treatment for a Uterine Rupture?

A

Immediate laparotomy and delivery of fetus

34
Q

In women who had Uterine Ruptures, how will their future pregnancies need to be delivered?

A

C-section

35
Q

What is Vasa Previa?

A

Rupture of a fetal vessel

36
Q

Describe how Vasa Previa usually arises

A
  • Umbilical cord inserts far away from placenta
  • It’s vessels must traverse without protective wharton’s jelly
  • Unprotected vessels pass over cervical os
    = rupture
37
Q

Describe how Vasa Previa usually arises?

A
  • Umbilical cord inserts far away from the placenta
  • It’s vessels must traverse without protective wharton’s jelly
  • Unprotected vessels usually pass over cervical os
    = rupture
38
Q

What will be the signs of Vasa Previa?

A

Bleeding and FHR changes

39
Q

If DIC occurs, what occured?

A

Placental Abruption

40
Q

Painless vaginal bleeding =

Painful vaginal bleeding =

A 
Painless = Placenta Previa
Painful = Placental Abruption

ENRP (45 decks)

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