Bleeding in pregnancy Flashcards
what is antepartum haemorrhage defined as?
bleeding after 24 weeks
what are the common causes of bleeding in the 1st trimester
Spontaneous abortion
Ectopic pregnancy
Hydatidiform mole
what are the common causes of bleeding in the 2nd trimester?
Spontaneous abortion
Hydatidiform mole
Placental abruption
what are the common causes of bleeding in the 3rd trimester?
Bloody show
Placental abruption
Placenta praevia
Vasa praevia
other than pregnancy related causes what else should be considered
stis
cervical polyps
types of spontaneous abortions
threatened
missed/delayed
inevitable
incomplete
complete
what is the bleeding like in a threatened miscarriage and when does it occur?
painless vaginal bleeding
typically around 6-9 weeks
what is the bleeding like in a missed/delayed miscarriage?
light vaginal bleeding
symptoms of pregnancy disappear
what is the bleeding like and pain like in an incomplete miscarriage?
heavy bleeding and crampy, lower abdo pain
what is the bleeding like in a complete miscarriage?
little bleeding
what is a typical history for an ectopic pregnancy?
Typically history of 6-8 weeks amenorrhoea with lower abdominal pain (usually unilateral) initially and vaginal bleeding later.
shoulder tip pain
is cervical excitation present in an ectopic?
yes
when does bleeding occur with a hydatidiform mole?
Typically bleeding in first or early second trimester
what are the symptoms of pregnancy like with a hydatidiform mole?
exaggerated - e.g. hyperemesis
what is the uterus like in a hydatidiform mole?
large
what is the serum hCG like with a hydatidiform mole?
very high
what are the symptoms and signs of placental abruption?
Constant lower abdominal pain and, woman may be more shocked than is expected by visible blood loss.
Tender, tense uterus* with normal lie and presentation.
what happens to the foetal heart in placental abruption?
maybe distressed
what are the symptoms of placental praevia?
vaginal bleeding
no pain
non-tender uterus but lie and presentation maybe abnormal
what is vasa praevia?
Rupture of membranes followed immediately by vaginal bleeding.
what is happens to the foetal heart rhythm is vasa praevia?
bradycardia
