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old Sophomore cards > Bleeding During Pregnancy > Flashcards

Bleeding During Pregnancy Flashcards

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0
Q

What is usually the cause of bleeding the 12th week?

A

Ectopic pregnancy - tubal

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1
Q

Cause of Early bleeding (before 12 weeks)

A

Abortions

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2
Q

What is usually the cause of bleeding 2nd trimester?

A

Hydatidiform mole, incompetent cervix

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3
Q

What is usually the causes of bleeding 3rd trimester?

A

Placenta previa, abruptio placenta

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4
Q

What us the definition of abortion?

A

Loss of baby before 20 weeks

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5
Q

What is the definition of threatened abortion?

A

Has not lost the baby

The cervix is CLOSED

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6
Q

What are the signs of a threatened abortion?

A

Bleeding or spotting

Cramps

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7
Q

What percent of women go on to have a normal baby at term?

A

85%

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8
Q

What is the definition Inevitable abortion?

A

Loss will occur

*cervix is OPEN and dilating

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9
Q

What are the signs of inevitable abortion?

A

Cramping, heaving bleeding, membranes may rupture, products of concepts not expelled, fluid in the cvx

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10
Q

What is the definition of incomplete abortion?

A

Parts of conceptus are expelled + parts retained

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11
Q

What are the signs of an incomplete abortion?

A

Cramping + bleeding
Open cervical os
Bleeds until all parts expelled

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12
Q

What is the definition of a complete abortion?

A

All the products of conception are passed

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13
Q

What is the definition of a missed abortion?

A

Fetus dies in the uterus but is not expelled

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14
Q

What may client complain of when they have a missed abortion?

A

Malaise
Headache
Anorexia

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15
Q

What takes place after abortion?

A

Uterine growth ceases
Negative pregnancy test
Ultrasound confirmation

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16
Q

What may prolonged retention of fetus result in?

A

Dissemination intra-vascular coagulation (abnormal clots throughout body)

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17
Q

When is the definition of Habitual abortion?

A

Incompetent cervical os

NO pain, no warning

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18
Q

What is usually the cause of a habitual abortion?

A

Thyroid disorder

Faulty uterine environment

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19
Q

What is the treatment of a habitual abortion?

A

Cerclage - stitch to close cervix

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20
Q

What is the definition of therapeutic abortion?

A

Instrumental termination of pregnancy by physician because of grave maternal disease of fetal defect

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21
Q

What does ETOP stand for?

A

Elective termination of pregnancy

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22
Q

What is blighted ovum

A

Nature’s abortion

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23
Q

What is the treatment of slight vaginal bleeding without pain?

A

Bed-rest
Avoid coitus
Count pads
Avoid straining - use stool softener

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24
Q

What needs to be counseled when women have slight vaginal bleeding without pain?

A

That 85% will have normal babies at term

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25
Q

What is the treatment when there is bleeding with pain?

A

“empty the uterus & make it contract”
Ultrasound
Asses coping ability

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26
Q

What kind of pregnancy is any gestation in which implantation of the blastocyst occurs outside the uterine cavity?

A

Ectopic pregnancy

27
Q

What are the symptoms of ectopic pregnancy?

A

Menstrual abnormality
Lower abdominal pain
Symptoms of pregnancy

28
Q

What is the fold standard for diagnosis for ectopic pregnancy?

A

Laproscopy

29
Q

What are the laboratory tests results of an ectopic pregnancy?

A

Low levels of hCG, Beta subunit radioassay

30
Q

What is found in the physical exam of a ectopic pregnancy?

A

Small uterus
Movement or cervix = pain
H&H LOW
BP may reflect total blood loss

31
Q

What is takes place in a linear salpinogostomy?

A

Linear incision to remove embryo from tube - allows future fertility

32
Q

What is the chemical management of an ectopic pregnancy?

A

Methotrexate

33
Q

What is methotrexate treatment?

A

Inhibits DNA synthesis so cells do not grow in ectopic pregnancy

34
Q

What is a gestational trophoblastic disease (GTD)?

A

Hydatidiform Mole

35
Q

When is there bleeding in Hydatidiform mole?

A

In 1st or 2nd trimester

36
Q

What races are Hydatidiform mole fairly common in?

A

Asians and people from the middle east

37
Q

What are Hydatidiform moles?

A

Abnormalities in fertilization - bleeding in 1st or 2nd trimester

38
Q

What kind of Hydatidiform mole when fertilization of an egg whose nucleus has been lost or inactivated?

A

Complete mole

39
Q

2nd sperm starts to multiply, enlarge and become fluid filled

A

Complete mole

40
Q

What kind of Hydatidiform mole is triploid karyotype = 69 chromosomes?

A

Partial mole

41
Q

What is it when there is 2 sperm and 1 maternal set of chromosomes or 1 paternal and 2 maternal sets?

A

Partial mole

42
Q

What becomes swollen in a Hydatidiform mole?

A

Chorionic villi - becomes fluid filled (hydropic)

43
Q

What are the symptoms of a Hydatidiform mole?

A

Vaginal bleeding
Anemia
Excessive N&V
Abdominal cramps

44
Q

What is the significance of a Hydatidiform mole?

A

Choriocarcinoma

A malignant neoplasm

45
Q

What us the treatment of a Hydatidiform mole?

A

Evacuation of the mole

46
Q

What is the follow-up after removal of a Hydatidiform mole?

A

Monitor HcG titer until there is 3 negative

47
Q

What are HCG levels with a Hydatidiform mole?

A

High

48
Q

Pregnancy in which the placenta is implanted in the lower part of the uterus - can cause bleeding in late pregnancy

A

Placenta Praevia

49
Q

Low placenta implantation praevia

A

Normal just low

50
Q

Three types of placenta praevia

A

Low placental implantation
Partial placental praevia
Complete placenta praevia

51
Q

Covers external os - more common in women with previous c-section

A

.

52
Q

What are the symptoms of placenta praevia?

A

Painless
Uterus stays soft
Bright red bleeding 2nd half of pregnancy

53
Q

Why does uterus stay soft with a placenta praevia?

A

Because blood is escaping vaginally

54
Q

What is the management in a placenta praevia?

A 
CBC
18th cathlon
NO vaginal exams
Pad count + weigh
36-37 weeks can deliver
55
Q

When can there be a vaginal birth with a placenta praevia?

A

If preavia is marginal and head down without much bleeding

56
Q

What is it called if there is a premature separation of the normally implanted placenta?

A

Abruptio Placenta

57
Q

What does it mean if there was a marginal abruptio placenta?

A

Placenta tears away at the edge first and escapes of blood vaginally

58
Q

What does it mean if there is central abruptio placenta?

A

Pop in the center of the placenta results in concealed bleeding

59
Q

What does is mean if there is a complete abruptio placenta?

A

Whole thing separates

60
Q

What are the symptoms of abruptio placenta?

A 
Pain
Firm uterus 
Uterine hypertonicity 
Shock disproprotional to estimated  blood loss 
Changes in FHR
61
Q

Uterine hypertonicity

A

Less resting tone

62
Q

What kind if bleeding is caused by abruptio placenta?

A

Uterine bleeding with small to moderate amount or dark red vaginal bleeding

63
Q

What are the changes in FHR with abruptio placenta?

A

Bradycarida

Repetitive decels

64
Q

If woman presents with dark red vaginal bleeding, c/o uterine tenderness what do you need to check?

A

Check V.S. and FHR promptly

65
Q

How is abruptio placenta diagnosed?

A

Retroplacental clot
Blood in amnionic fluid
Fall in H&H
Fall in coagulation factors (10-30%)

66
Q

Why may mother develop coagulopathies with an abruptio placenta?

A

Because myometrial tissue is damaged resulting in thromboplastin release

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