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maternal newborn > CH 7 Bleeding During Pregnancy > Flashcards

CH 7 Bleeding During Pregnancy Flashcards

1
Q

What are signs and symptoms of a spontaneous abortion

A

Vaginal bleeding, uterine cramping, and partial or incomplete expulsion of products of conception.

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2
Q

What are signs and symptoms of a ectopic pregnancy

A

Abrupt unilateral lower quadrant abdominal pain with or without vaginal bleeding

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3
Q

What is the main cause of bleeding during the 2nd trimester

A

Gestational trophoblastic disease

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4
Q

What are signs and symptoms of gestational trophoblastic disease

A

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

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5
Q

What are the main causes of bleeding during the third trimester

A

Placenta previa

Abruptio placenta

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6
Q

What are the signs and symptoms of placenta previa

A

Painless vaginal bleeding

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7
Q

What are signs and symptoms of abruptio placenta

A

Vaginal bleeding, sharp abdominalain, and tender rigid uterus

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8
Q

What are 2 other cause of bleeding during pregnancy

A

Procurrent premature dilation of the cervix

Preterm labor

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9
Q

What is precurrent dilation of the cervix

A

Painless bleeding with cervical dilation leading to fetal expulsion

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10
Q

What is preterm labor

A

Pink stained vaginal discharge, uterine contractions becoming regular, cervical dilation and effacement

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11
Q

What is a spontaneous abortion

A

It is when a pregnancy is terminated before 29 weeks ( the point of viability or a fetal wt less than 500g)

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12
Q

Name the 5 types of abortions

A 
Threatened
Inevitable
Incomplete
Complete 
Missed
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13
Q

What are signs and symptoms of hemmorhage

A

Hypotension
Tachycardia
Pallor

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14
Q

What is a threatened abortion

A

No tissue is passed
Cervical opening is closed
Bleeding ranges from spotting to moderate
With or without cramps can be experienced

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15
Q

What is a inevitable abortion

A

No tissue is passed
The cervical opening is dilated with membranes or tissue bulging at cervix
Bleeding is mild to severe
Cramps are moderate

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16
Q

What is a incomplete abortion

A

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

17
Q

What is a complete abortion

A

Mild cramps
Minimal bleeding
Complete expulsion of uterine contents
The cervical opening is closed with no tissue in cervical canal

18
Q

What is a missed abortion

A

No cramps
Brownish discharge
No tissue passed with prolonged retention of tissue
Cervical opening is closed

19
Q

D&C dilation and curettage

A

To dilate and scrape the uterine walls to remove uterine contents for inevitable and complete abortions

20
Q

D&E dilation and evacuation

A

To dilate and evacuate uterine contents after 16 weeks of gestation

21
Q

What is the 2nd most frequent cause of bleeding In early pregnancy and cause of infertility

A

Ectopic pregnancies

22
Q

What is a salpingostomy

A

A prove endure to salvage the Fallopian tube if not ruptured in a ectopic

23
Q

What is a laparoscopic salpingectomy

A

The removal of a tube when the tube has ruptured

24
Q

What is administered that inhibits cell division and embryo enlargement, dissolving the pregnancy

A

Methotrexate (MTX)

25
Q

What is gestational trophoblastic disease

A

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.

26
Q

What is a complete mole

A

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

27
Q

What is a partial mole

A

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

28
Q

For molar pregnancy how often should serum hCG levels be checked

A

It is to be done weekly for 3 weeks then monthly for 6 months to a year to detect GTD

29
Q

What is placenta previa

A

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

30
Q

How is placenta previa classified

A

They are classified into three types dependent on the degree to which the cervical os is covered by the placenta

31
Q

Name and describe the 3 types of placenta previa

A
  1. Complete or total- cervical os is completely covered by the placental attachment
  2. 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
32
Q

What does Leopold maneuvers do

A

Determined fetal position and presentation

33
Q

What is abruptio placenta

A

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.

34
Q

What are causes of bleeding during pregnancy during the first trimester

A

Spontaneous abortion or ectopic pregnancy

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