Antepartum hemorrhage Flashcards
placenta adheres to uterine wall
placenta accreta
placenta invades into myometrium
increta
placenta penetrates through to uterine serosa
percreta
membranes form dense ring around placenta
circumvallate placenta
fetal vessels develop over internal os
vasa previa
fetal vessels insert between amnion and chorion
velamentous placenta
extra lobe of placenta ± blood fetal vessels between two lobes
succenturiate placenta
4 causes of third trimester hemorrhage
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
3 subtypes of previa
complete, partial, marginal
previa painful or painless?
painless
suspect placenta previa, next step?
labs to get?
transabd or vag US (if <34 wks, give tocolytics and beta)
H&H, Type and cross
usually asx during pregnancy, presents as vaginal bleed + inability to separate placenta after delivery
accreata, increta, percreta
3rd trimester vaginal bleeding + severe abd pain, strong ctx
placental abruption
risk factors for abruption
HTN > trauma, previous abruption, smoking, cocaine
vaginal bleeding + sinusoidal pattern on FHR [tachy → brady → sinusoidal
fetal vessel rupture