APH

Question 1

PLACENTA PREVIA (ETIOLOGY)

Answer 1

• Deficient endometrium;CS..
•Previous PP
•ART
•Advanced maternal age (>40 years)
•2nd pregnancy within 1 yr of CS •Multiparity
•Multiple gestation
•Smoking

Question 2

lacenta Previa (complications)
Maternal

Answer 2

• hypovolemic shock
■ postpartum hemorrhage because of uterine inertia (UTERINE ATONY)
■ Placenta previa may be associated with placenta accreta, placenta
increta or percreta.
■ Coagulopathy is rare with placenta previa.
■ Prolong hospital stay
■ Injuries related to surgery

Question 3

Placenta Previa (complications)

Answer 3

■ Prematurity
• Double the rate of fetal congenital malformations
• Fetal malpresentation
• Velamentous cord insertion and Vb ■ Fetal growth restriction
■ Fetal hypoxia / DEATH (EXTREME CASES)

Question 4

Abruptio placenta risk factor

Answer 4

• Abruption in a previous pregnancy.
• Pre-eclampsia, hypertension
• FGR
• Polyhydramnios
• PROM
• Advanced maternal age
• Multiparity
• ART
• Abdominal trauma
• Smoking and drug misuse

Question 5

Placental Abruption (PRESENTATION)

Answer 5

◦ Fetal distress - 60%
◦ Abnormal uterine contractions - 35%
◦ Idiopathic premature labor - 25%
unknown
◦ Fetal death - 15%

Question 6

Complications of abruptio placentae

Answer 6

■ Maternal shock
■ IUGR ,IUFD
■ Uterine atony
■ Couvelaire Uterus a
■ Amniotic fluid embolism
■ Coagulopathy( 30%)
■ Renal failure
The principal cause of maternal death is renal failure due to prolonged hypotension .
• Do not underestimate the amount of the hemorrhage •

Question 7

What’s the cases lead to immediate delivery in abruptio placenta

Answer 7

■ Fetus at term/beyond e
■ Fetus is dead
■ Moderate to severe abruption i signAidpain
■ Developing coagulopathy
■ Pt IS IN ADVANCED LABOUR

Question 8

What’s the cases lead to expectant management in abruptio placenta

Answer 8

• IF ABRUPTION IS MILD
• Asymptomatic/minimal symptoms.
• NO MATERNAL/FETAL COMPROMISE
• No coagulopathy