bleeding disorders Flashcards
HYPOVOLEMIC SHOCK
blood loss amounting to
1.5 –2 L.
Hemorrhage - occurs
during pregnancy, labor & delivery
Perinatal
anytime
during pregnancy
Antepartal hemorrhage
termination of pregnancy
before 12 weeks (fetus is
< 500gms)
Early abortion
termination of pregnancy occurs
between 12 to 20 weeks
Late abortion
1st trimester bleeding:
Abortion & Ectopic
Pregnancy
2nd trimester bleeding:
Hydatidiform Mole &
Incompetent Cervix
3rd trimester: bleeding:
Placenta previa
& Abruptio Placenta
by personal
choice type of Abortion
Elective abortion
due to natural
causes; unexpected ending of
pregnancy
Spontaneous Abortion
4 stages of abortion
Threatened abortion
Inevitable abortion
Incomplete abortion
Complete abortion
one of the causes of abortion is the inadequate production of what hormone
progesterone
occurs when clotting occurs in placental vessels and It blocks placental growth
Antiphospholipid Antibody Syndrome
Prophylaxis to Prevent
Miscarriages
Oral low-dose aspirin
Heparin (SQ)
If heparin & aspirin alone are not
adequate for APS, what is administered
IV immunoglobulin
infusion or corticosteroid
administration
Possible loss of the
products of conception.
THREATENED ABORTION
Light vaginal bleeding
(scanty, bright red)
No cervical dilatation
None to mild uterine
cramping
THREATENED ABORTION
MANAGEMENT FOR THREATENED ABORTION
Conservative management
HCG monitoring
Conservative Management
of Threatened Abortion
no medical therapy
Bedrest until 3 days
Hormonal Therapy
loss of the product of
conception that cannot be
prevented.
INEVITABLE OR
IMMINENT ABORTION
Moderate to profuse bleeding
Moderate to severe uterine
cramping
Open cervix or dilatation of
cervix
INEVITABLE OR
IMMINENT ABORTION
MANAGEMENT FOR INEVITABLE OR
IMMINENT ABORTION
Vacuum Extraction or
Dilatation & Curettage
Dilatation & Evacuation
Oxytocin after D&C
Spontaneous expulsion of the products of
conception.
COMPLETE ABORTION
Light bleeding or some blood
No tenderness in the cervix, uterus, or abdomen
None to mild uterine cramping
Closed cervix
Empty uterus on ultrasound
COMPLETE ABORTION
Heavy vaginal bleeding
Severe uterine cramping
Open cervix
Passage of tissue
INCOMPLETE
ABORTION
Retention of all products of
conception after the death of a fetus in the uterus.
MISSED ABORTION
Absence of Fetal Heart
Tone (FHT)
Signs of early pregnancy
symptoms disappearing,
e.g., nausea & breast
soreness
SIGNS & SYMPTOMS
MANAGEMENT FOR MISSED ABORTION
inserting 20mg
dinoprostone
vagina q 3 or 4 hrs.
Dilute IV infusion of oxytocin
to expel conceptus.
Infection complicates the dissemination of bacteria & toxins into the maternal circulatory and organ
systems.
SEPTIC ABORTION
SIGNS & SYMPTOMS : SEPTIC ABORTION
Foul - smelling vaginal
discharge
Uterine cramping
Fever, chills & peritonitis
Leukocytosis – WBC count,
16,000 to 22,000/uL
Critically ill patients may have evidence of septic or endotoxic shock with vasomotor with this type of abortion
SEPTIC ABORTION
Hypothermia, Hypotension
Oliguria or anuria
and Respiratory distress are common in this type of abortion
SEPTIC ABORTION
MANAGEMENT FOR SEPTIC ABORTION
High dose of antibiotic therapy
Penicillin for gram (-)
microorganisms
Clindamycin & tobramycin for
gram (+)
D&C
administered to
maintain sufficient cardiac output
Dopamine & digitalis
