Antepartum hemorrhage Flashcards

1
Q

placenta adheres to uterine wall

A

placenta accreta

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2
Q

placenta invades into myometrium

A

increta

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3
Q

placenta penetrates through to uterine serosa

A

percreta

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4
Q

membranes form dense ring around placenta

A

circumvallate placenta

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5
Q

fetal vessels develop over internal os

A

vasa previa

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6
Q

fetal vessels insert between amnion and chorion

A

velamentous placenta

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7
Q

extra lobe of placenta ± blood fetal vessels between two lobes

A

succenturiate placenta

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8
Q

4 causes of third trimester hemorrhage

A

Obstetric causes: placenta previa (20%), abruptio placentae (30%), fetal vessel rupture, uterine rupture

Non-obstetric causes: cervical/vaginal lacerations, hemorrhoids, infx, neoplasms
**non-obstetric present as spotting, no ctx, no abd pain

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9
Q

3 subtypes of previa

A

complete, partial, marginal

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10
Q

previa painful or painless?

A

painless

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11
Q

suspect placenta previa, next step?

labs to get?

A

transabd or vag US (if <34 wks, give tocolytics and beta)

H&H, Type and cross

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12
Q

usually asx during pregnancy, presents as vaginal bleed + inability to separate placenta after delivery

A

accreata, increta, percreta

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13
Q

3rd trimester vaginal bleeding + severe abd pain, strong ctx

A

placental abruption

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14
Q

risk factors for abruption

A

HTN > trauma, previous abruption, smoking, cocaine

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15
Q

vaginal bleeding + sinusoidal pattern on FHR [tachy → brady → sinusoidal

A

fetal vessel rupture

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16
Q

how is fetal vessel rupture diagnosed

A

Apt test (examine blood for fetal/nucleated RBCs, pink indicates fetal blood)

17
Q

what are the 3 common causes of fetal vessel rupture

A

Vasa previa: fetal vessels develop over internal os

Velamentous placenta: fetal vessels insert between amnion and chorion

Succenturiate placenta: extra lobe of placenta ± blood fetal vessels between two lobes