CH 7 Bleeding During Pregnancy Flashcards
What are signs and symptoms of a spontaneous abortion
Vaginal bleeding, uterine cramping, and partial or incomplete expulsion of products of conception.
What are signs and symptoms of a ectopic pregnancy
Abrupt unilateral lower quadrant abdominal pain with or without vaginal bleeding
What is the main cause of bleeding during the 2nd trimester
Gestational trophoblastic disease
What are signs and symptoms of gestational trophoblastic disease
The uterine size increasing abnormally fast, abnormally high levels of hCG, nausea and increased emesis,no fetus present on ultrasound, and scant or profuse dark brown or or red vaginal bleeding
What are the main causes of bleeding during the third trimester
Placenta previa
Abruptio placenta
What are the signs and symptoms of placenta previa
Painless vaginal bleeding
What are signs and symptoms of abruptio placenta
Vaginal bleeding, sharp abdominalain, and tender rigid uterus
What are 2 other cause of bleeding during pregnancy
Procurrent premature dilation of the cervix
Preterm labor
What is precurrent dilation of the cervix
Painless bleeding with cervical dilation leading to fetal expulsion
What is preterm labor
Pink stained vaginal discharge, uterine contractions becoming regular, cervical dilation and effacement
What is a spontaneous abortion
It is when a pregnancy is terminated before 29 weeks ( the point of viability or a fetal wt less than 500g)
Name the 5 types of abortions
Threatened Inevitable Incomplete Complete Missed
What are signs and symptoms of hemmorhage
Hypotension
Tachycardia
Pallor
What is a threatened abortion
No tissue is passed
Cervical opening is closed
Bleeding ranges from spotting to moderate
With or without cramps can be experienced
What is a inevitable abortion
No tissue is passed
The cervical opening is dilated with membranes or tissue bulging at cervix
Bleeding is mild to severe
Cramps are moderate
What is a incomplete abortion
Severe cramps
Copious and severe bleeding
Partial fetal tissue or placenta passed
The cervical opening is dilated with tissue in cervical canal or passage of tissue
What is a complete abortion
Mild cramps
Minimal bleeding
Complete expulsion of uterine contents
The cervical opening is closed with no tissue in cervical canal
What is a missed abortion
No cramps
Brownish discharge
No tissue passed with prolonged retention of tissue
Cervical opening is closed
D&C dilation and curettage
To dilate and scrape the uterine walls to remove uterine contents for inevitable and complete abortions
D&E dilation and evacuation
To dilate and evacuate uterine contents after 16 weeks of gestation
What is the 2nd most frequent cause of bleeding In early pregnancy and cause of infertility
Ectopic pregnancies
What is a salpingostomy
A prove endure to salvage the Fallopian tube if not ruptured in a ectopic
What is a laparoscopic salpingectomy
The removal of a tube when the tube has ruptured
What is administered that inhibits cell division and embryo enlargement, dissolving the pregnancy
Methotrexate (MTX)
What is gestational trophoblastic disease
It is the proliferation and degeneration of trophoblastic villi in the placenta that becomes swollen, fluid filled, and takes on the appearance of grape like clusters, the embryo fails to develop beyond a primitive state and these structures are assoc with choriocarcinoma, which is a rapidly metastasizing malignancy.
What is a complete mole
All genetic material is paternally derived
The ovum has no genetic material or the material is inactive
It contains no fetus, placenta, amniotic membranes or fluid
There is no placenta to receive maternal blood, therefore hemmorhage into the uterine cavity occurs and vaginal bleeding results
What is a partial mole
Genetic material is derived both maternal,y and paternally
A normal ovum is fertilized by 2 sperm or 1 sperm in which meiosis or chromosome reduction and division did not occur
A partial mole contains abnormal embryonic or fetal parts an amniotic sac, and fetal blood but congenital anomalies are present
For molar pregnancy how often should serum hCG levels be checked
It is to be done weekly for 3 weeks then monthly for 6 months to a year to detect GTD
What is placenta previa
It occurs when the placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the fundus, the abnormal implantation results in bleeding during the 3 Ed trimester as the cervix begins to dilate and efface
How is placenta previa classified
They are classified into three types dependent on the degree to which the cervical os is covered by the placenta
Name and describe the 3 types of placenta previa
- Complete or total- cervical os is completely covered by the placental attachment
- incomplete or partial- cervical os is only partially covered by the placental attachment
- marginal or low lying- the placenta is attached in the lower uterine segment but does not reach the cervical os
What does Leopold maneuvers do
Determined fetal position and presentation
What is abruptio placenta
It is the premature separation of the placenta fro the uterus which can be a partial or complete detachment
This separation occurs after 20 weeks gestation. It has significant maternal and fetal morbidity. And is a leading cause of maternal death.
What are causes of bleeding during pregnancy during the first trimester
Spontaneous abortion or ectopic pregnancy
