APH (04/11/2021) Flashcards
What is the definition of an APH?
Bleeding from the genital tract occurring from 24+ weeks of pregnancy and prior to the birth of the baby.
What is placenta praaevia?
Placenta wholly or partly in the lower uterine segment. The placenta lies directly over the internal os. Low-lying placenta should be used when the placental edge is less than 20mm from the internal os over 16 weeks gestation. The blastocyst implants low in the uterus. Incidence is 1 in 200 pregnancies at term.
How is placenta praevia diagnosed?
Found on 20 week scan. Follow up reccommended for further TVS and uss at 32 weeks gestation to check for placenta praaevia or low lying placenta.
What is placenta accreta?
Abnormal adherence of the placenta in whole or in parts to the underlying uterine wall in partial or complete absence of the decidua.
Describe AN care for women with low lying placenta?
Single course of AN corticosteroid therapy is recommended between 34 and 35+6 for women with a low-lying placenta or placenta praevia.
- No VE
- IV access
- Group and cross match
- Blood available 2 units held on labour ward
Is a vaginal delivery appropriate for women with a low-lying placenta?
- If the placenta edge <20mm from the internal os most be need C-section
- Especially if posterior placenta
- Lower segment continues to develop after 36 weeks, TV scan if head engaged prior to planned CS.
- Cross matched blood 4 units on labour ward
- C-section by most experienced obstetrician and anaethesist available.
What is placenta accreta?
-Morbid adherence of the placenta to the uterine wall. HIGH risk of PPH. Usually hysterectomy will be offered during the C-section in order to control bleeding. Referral needed to a tertiary centre.
What is vasa praevia?
When fetal vessels run through the placental membranes. Unprotected by placental tissue or whartons jelly, so likely to rupture in active labour or amniotomy.
