Bleeding Conditions During Pregnancy Flashcards
1
Q
What does Hmole stand for?
A
Hydatidiform Mole
2
Q
Is it normal to bleed during pregnancy?
A
No
3
Q
What are the bleeding conditions during 1st Trimester?
A
- Abortion
- Ectopic Pregnancy
4
Q
Bleeding conditions during 2nd trimester?
A
- Hydatidiform Mole
- Incompetent Cervix
5
Q
Bleeding conditions during 3rd trimester?
A
- Placenta Previa
- Abruptio Placenta
- Preterm Labor
6
Q
Why is it dangerous to have bleeding during pregnancy?
A
- Placental Loosening
- Just a fraction of total bleeding
- Uterus is a non-essential organ
7
Q
Termination of pregnancy before the age of viability.
What is the age of viability?
A
Abortion
20-24 weeks AOG
8
Q
If the baby is less than 500g, what does it mean?
A
Abortus
9
Q
If the baby is more than 500g, what does it mean?
A
Parity
10
Q
Causes of spontaneous miscarriage?
A
- Chromosomal Abnormalities
- Implantation Problems
- TORCH Infections
11
Q
Different types of abortion
A
- Threatened
- Imminent
- Complete
- Incomplete
- Missed
12
Q
What is threatened abortion?
A
- Will not always lead to abortion
- No cervical dilation
- Cramping & Bleeding
13
Q
What is imminent abortion?
A
- Will always lead to abortion
- Cervical dilation
- Cramping & Bleeding
- Rupture of Membrane (ROM)
14
Q
What is complete abortion?
A
- All products are expelled
- After 2 hrs, bleeding stops
15
Q
What is incomplete abortion?
A
- Some products are retained
- Bleeding continues
- Dilatation and Curattage
16
Q
What is missed abortion?
A
- All products are retained
- Bleeding will continue
- Induced pregnancy
- May develop into Disseminated Intravascular Coagulation
17
Q
Implantation outside the uterus
A
Ectopic Pregnancy
18
Q
Where is the common site of implantation inectopic pregnancy?
A
Ampulla
19
Q
Causes of ectopic pregnancy
A
- Congenital malformations
- Adhesions
- Tumors
- Scars from previous surgeries
20
Q
Assessment for ectopic pregnancy
A
- Sharp stabbing pain in lower quadrant
- Rigid abdomen
- Cullen’s Sign
- Shoulder pain
- Leukocytosis
- Signs of SHOCK
21
Q
If unruptured, what should you give to manage ectopic pregnancy?
A
Methotrexate
22
Q
If ruptured, what should you do to manage ectopic pregnancy?
A
Salpingectomy or suturing using a micro surgical technique
23
Q
What procedure is done during Abdominal Pregnancy?
A
Laparotomy
24
Q
What is Hmole?
A
Abnormal proliferation and Degeneration of trophoblastic cells
25
A condition wherein the mother is pregnant with no baby. No embryoblast, only trophoblast.
Hydatidiform Mole
26
Who are in risk of Hmole?
- Asians
- Low-protein Diet people
- Type A women + Type O men pair
27
What produces the HCG?
Trophoblastic cells
28
What does HCG do?
- Ensures corpus luteum survives up to 2 months
- Reverse peristalsis
- Used to detect pregnancy
29
Manifestations of Hmole
1. Hyper Emesis Gravidarum
2. Unusually large abdomen
3. Grape-like Vesicles
30
Kinds of Hmole
1. Complete Mole
| 2. Partial Mole
31
Type of Hmole wherein ovum has no chromosomal material. Sperm multiplies its own chromosomal material.
Complete Mole
32
Type of Hmole wherein 2 sperms penetrate 1 ovum
Partial Mole
33
How many chromosomes are formed in Partial Mole?
69 chromosomes
34
How many chromosomes are formed in Complete Mole?
46 chromosomes
35
Assessment for Hmole
- Vaginal bleeding with passage of fluid-filled vesicles
- Rapid uterine enlargement
- High levels of HCG
- Marked emesis
- Snowflake pattern on UTZ
36
What procedure is done to manage Hmole?
- Suction Curettage
| - Methotrexate (add Dactinomycin if with metastasis)
37
Refers to the low implantation of the placenta
Placenta Previa
38
When does Placenta Previa usually occur?
30 weeks AOG
39
Symptoms of Placenta Previa
Painless, Bright Red Bleeding
40
Placenta Previa associated factors
- Increased Parity
- Advanced Maternal Age
- Past Cesarean Births
- Past Uterine Curettage
- Multiple Gestation
41
If indention is severe, this may indicate that the uterus is about to rupture
Bandl's Ring
42
Types of Placenta Previa
- Total
- Partial
- Marginal
- Low-lying
43
Describe Total Placenta Previa
- Totally obstructs the cervix
| - Cesarean
44
Describe Partial Placenta Previa
- Partially obstructs the cervix
| - Cesarean
45
Describe Marginal Placenta Previa
- Lies on the margins
| - NSVD
46
Describe Low-lying Placenta Previa
- Not in the margin but still on lower portion
| - NSVD
47
Common risk factors for Placenta Previa
1. Multiple parity
2. Multiple pregnancies
3. Scars
48
Management of Placenta Previa
1. No IE
2. Bed rest
3. Insert IV gauge 19
49
Premature placental separation while baby is still inside mother's womb
Abruptio Placenta
50
Risk factors of Abruptio Placenta
1. Trauma (short umbilicus)
| 2. Degeneration of Decidua (caused by cocaine, smoking, advanced maternal age, PIH and chronic hypertension)
51
Abruptio placenta assessment
- May occur late in labor
- Tenderness upon palpation
- Heavy - dark red bleeding
- Couvelaire uterus [rigid uterus]
- Fetal prognosis depends on the extent of the placental separation
- Maternal prognosis depends on how promptly treatment can be instituted
52
What is DIC?
Disseminated Intravascular Coagulation
53
Acquired disorder of blood clotting
Disseminated Intravascular Coagulation
54
What causes DIC?
- Pregnancy Induced Hypertension
- Retained dead fetus
- Placenta Previa
- Abruptio Placenta
55
What test is done during Abruptio Placenta?
Test Tube Test
56
In labor prior to 37 weeks
Preterm Labor
57
Major causes of Preterm Labor
- Dehydration
- Urinary Tract Infections
- Chorioamnionitis
58
What hormones are contained in the Posterior Pituitary Gland?
- Anti-diuretic Hormone
| - Oxytocin
59
Hormone which causes the uterus to contract
Oxytocin
60
Hormone that stops a person from urinating; conserves fluid
Anti-diuretic Hormone
61
Preterm baby risks
- Immunity issues
- Lungs not fully developed
- Brain is not mature
- Testes undescended
62
Signs and indications of Preterm Labor
- Low back pain
- Uterine contractions
- Cervical dilation
- Vaginal bleeding
- Feelings of pelvic pressure
63
What is the first thing you should do if a pregnant woman comes into the clinic?
Ask for AOG
64
Nursing interventions if a woman comes into the clinic
- Put in bed rest
| - Insert IV Fluid
65
Theory in which the more the cervix is pressed, the more prostaglandin is released
Cervical Pressure Theory
66
What is given to enhance lung maturity (preterm labor)
Corticos Steroid or Betamethasone
67
How long until betamethasone takes effect? (preterm)
24 hrs
68
This is a smooth muscle relaxant given to mother (preterm)
Terbutaline bricanyl
69
Premature cervical dilation
Incompetent Cervix
70
Placement of stitches in the cervix to hold it closed (incompetent cervix)
Cervical Cerclage
71
What are the two types of cerclage and when is it given?
- Shirodkar cerclage if cesarean
| - Mcdonald's cerclage if NSVD
