Bleeding_in_Pregnancy_Flashcards
What is antepartum haemorrhage?
Antepartum haemorrhage is defined as bleeding after 24 weeks of pregnancy.
What are the major causes of bleeding during the 1st trimester of pregnancy?
The major causes of bleeding during the 1st trimester of pregnancy are spontaneous abortion, ectopic pregnancy, and hydatidiform mole.
What are the major causes of bleeding during the 2nd trimester of pregnancy?
The major causes of bleeding during the 2nd trimester of pregnancy are spontaneous abortion, hydatidiform mole, placental abruption, and bloody show.
What are the major causes of bleeding during the 3rd trimester of pregnancy?
The major causes of bleeding during the 3rd trimester of pregnancy are placental abruption, placenta praevia, and vasa praevia.
What conditions should be excluded alongside pregnancy-related causes of bleeding?
Conditions such as sexually transmitted infections and cervical polyps should be excluded alongside pregnancy-related causes of bleeding.
What are the key features of spontaneous abortion?
Key features of spontaneous abortion include threatened miscarriage (painless vaginal bleeding around 6-9 weeks), missed (delayed) miscarriage (light vaginal bleeding and disappearance of pregnancy symptoms), and inevitable miscarriage (complete or incomplete depending on whether all fetal and placental tissue has been expelled). Incomplete miscarriage involves heavy bleeding and crampy lower abdominal pain, while complete miscarriage involves little bleeding.
What are the key features of an ectopic pregnancy?
Key features of an ectopic pregnancy include a history of 6-8 weeks amenorrhoea with lower abdominal pain (usually unilateral) initially and vaginal bleeding later. Shoulder tip pain and cervical excitation may be present.
What are the key features of a hydatidiform mole?
Key features of a hydatidiform mole include bleeding in the first or early second trimester associated with exaggerated symptoms of pregnancy such as hyperemesis. The uterus may be large for dates and serum hCG is very high.
What are the key features of placental abruption?
Key features of placental abruption include constant lower abdominal pain, shock disproportionate to visible blood loss, tender and tense uterus with normal lie and presentation, and fetal heart distress.
What are the key features of placental praevia?
Key features of placental praevia include vaginal bleeding without pain, a non-tender uterus, and abnormal lie and presentation.
What are the key features of vasa praevia?
Key features of vasa praevia include rupture of membranes followed immediately by vaginal bleeding and fetal bradycardia.
Why should vaginal examination not be performed in primary care for suspected antepartum haemorrhage?
Vaginal examination should not be performed in primary care for suspected antepartum haemorrhage because women with placenta praevia may haemorrhage.
Summarise Bleeding in pregnancy
Theme: Bleeding in pregnancy
A. Placental abruption
B. Ectopic pregnancy
C. Threatened miscarriage
D. Hydatidiform mole
E. Vasa praevia
F. Placenta praevia
G. Bloody show
H. Missed (delayed) miscarriage
I. Inevitable miscarriage
For each one of the following scenarios select the most likely diagnosis:
- A 25-year-old woman at 25 weeks gestation presents with constant lower abdominal pain and a small amount of vaginal bleeding. On examination blood pressure is 90 / 60 mmHg
- A 31-year-old woman presents with painless vaginal bleeding at 15 weeks gestation. She has not yet had any antenatal care despite suffering from severe vomiting. On examination the uterus is large for dates
- A 19-year-old woman presents with a two day history of central lower abdominal pain and one day history of vaginal bleeding. Her last period was 8 weeks ago. On examination her cervix is tender to touch
Theme: Bleeding in pregnancy
A. Placental abruption
B. Ectopic pregnancy
C. Threatened miscarriage
D. Hydatidiform mole
E. Vasa praevia
F. Placenta praevia
G. Bloody show
H. Missed (delayed) miscarriage
I. Inevitable miscarriage
For each one of the following scenarios select the most likely diagnosis:
- A 25-year-old woman at 25 weeks gestation presents with constant lower abdominal pain and a small amount of vaginal bleeding. On examination blood pressure is 90 / 60 mmHg
Placental abruption
- A 31-year-old woman presents with painless vaginal bleeding at 15 weeks gestation. She has not yet had any antenatal care despite suffering from severe vomiting. On examination the uterus is large for dates
Hydatidiform mole - A 19-year-old woman presents with a two day history of central lower abdominal pain and one day history of vaginal bleeding. Her last period was 8 weeks ago. On examination her cervix is tender to touch
Ectopic pregnancy
