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OB 2 > Chapter 35: The Postpartum Uterus > Flashcards

Chapter 35: The Postpartum Uterus Flashcards

1
Q

formation of a blood clot owing to inflammation

A

thrombophlebitis

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2
Q

Radiographic examination of the vein performed after injection of a radiopaque contrast medium

A

Venogram

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3
Q

stones within the kidney

A

nephrolithiasis

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4
Q

radiographic images of the kidneys, ureters, and bladder after injection of a radiopaque dye

A

intravenous pyelogram

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5
Q

reduction of an organ to its normal size and appearance

A

involution

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6
Q

removal of the uterus

A

hysterectomy

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7
Q

collection of blood outside the vessels

A

hematoma

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8
Q

moving particles, such as thrombosis or air, within the bloodstream

A

emboli

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9
Q

portion of the uterine lining which forms the maternal portion of the placenta

A

decidua basalis

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10
Q

defect in the body’s clotting mechanism resulting in bleeding

A

coagulopathy

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11
Q

inflammation of the amnion and chorion owing to a bacterial infection

A

chorioamnionitis

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12
Q

lack of normal muscle tone

A

atony

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13
Q

The puerperium:
a. describes the postdelivery condition of the female external genitalia
b. starts immediately post delivery including the placenta and continues until the uterus retains it prenatal shape
c. is an infection of the placental site within the uterus
d. extends from placental delivery until the first normal menstruation

A

b

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14
Q

Lactation termination usually produces:

A

menstrual resumption

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15
Q

sonography in the puerperium period is used for all except:
a. evaluation puerperal infection
b. postpartum hemorrhage
c. complications following cesarean delivery
d. to routinely determine whether the uterus has returned to prepregnancy state

A

d

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16
Q

Select the true statement regarding the postpartum uterus.
a. the internal os will be visualized as closed and well delineated following placental delivery
b. the endometrium will measure 3 to 8 mm within 24 hours of delivery
c. free fluid in the endometrial cavity indicates intrauterine infection
d. longitudinal uterine measurements range from 14 to 25 cm

A

d

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17
Q

during pregnancy, ovaries generally:
a. remain the same as prepregnancy state with the exception of a few more cysts in the first trimester
b. involute
c. enlarge owing to hormone production
d. develop a thickened outer cortex

A

a

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18
Q

A placenta that completely invades the uterine myometrium extending into the serosa is:

A

placenta percreta

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19
Q

Select the condition that is not likely to be related to postpartum hemorrhage.
a. decreased hematocit
b. shock
c. hypertension
d. hysterectomy

A

c

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20
Q

RPOC has a similar sonographic appearance to:

A

highly echogenic mass in the endometrial canal

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21
Q

Usually the first indication of uterine (pueperium) infection is:

A

uterine tenderness

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22
Q

the only infection that is not typically related to postpartum infection is:

A

salpingitis

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23
Q

which of the following is not identified with uterine atony?
a. chorioamnionitis
b. prolonged labor
c. oligohydramnios
d. macrosomy

A

c

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24
Q

The most common signs of POVT are:

A

fever, right sided pelvic mass, and pelvic pain

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25
Q

cesarean section delivery:
a. has an increased risk of infection
b. is mostly performed with a vertical incision
c. requires a low-frequency transducer when hematoma occurs adjacent to the bladder flap
d. accounts for approximately 13.8% of all US deliveries

A

a

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26
Q

the most frequent site of postpartum thrombophlebitis is:

A

right ovarian vein

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27
Q

Endometritis:
a. is an infection of the endometrium that may extend to the myometrium, which may lead to postpartum bleeding
b. appears as an extremely thin endometrium and irregular walls
c. produces a fluid-filled endometrium
d. causes a flaccid uterus post deliver

A

a

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28
Q

The postpartum period may also be called the ______

A

puerperium

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29
Q

complications seen most frequently following cesarean section are _____ and ____ at the incision site

A

Hematomas
Abscesses

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30
Q

It is essential to remember to use a _____ pressure than when imaging the nongravid uterus

A

Lighter

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31
Q

If a post C-section patient cannot tolerate trans abdominal or transvaginal imaging, the ____ or _____ imaging method may visualize the C-section incision

A

Translabial
Transperineal

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32
Q

The adnexal ligaments of the postpartum patient are typically _____ immediately following delivery, usually returning to their pregravid states within ______

A

Flaccid
1 month

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33
Q

Postpartum hemorrhage is considered over ____ mL of blood with a vaginal delivery and over _____ mL of blood in a cesarean delivery.

A

500
1000

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34
Q

The cause of placenta accreta, percreta, and increta is complete or partial absence of the _______

A

Decidua basalis

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35
Q

Antepartum rupture of the uterus causes emergency delivery and ______

A

Hysterectomy

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36
Q

Sonography helps identify the multiple intraplacental ____ that are indicators of placental invasion of the myometrium

A

Lakes

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37
Q

The sonographic appearance of endometritis is that of a _____, irregular endometrium that may have ______ in the endocervical canal.

A

Thick
Fluid

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38
Q

Retained products of conception image as an _____ mass within an irregularly shaped uterus

A

Echogenic

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39
Q

Sonographically, POVT images as a dilated anechoic to hypoechoic _____ structure extending superiorly from the adnexa

A

Tubular

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40
Q

Hematomas found in the bladder flap region are sonographically ______ with ill-defined borders that range in size from less than 1 cm to greater than 15cm

A

Anechoic

41
Q

A ____-frequency transducer is sometimes needed to adequately assess postpartum cesarean section hematomas

A

High

42
Q

Infections following cesarean sections have appearances of anechoic, _____, _____, and with or without definite margins

A

Cystic
Complex

43
Q

The postpartum period may also be called the:

A

puerperium

44
Q

period of time extending from immediately following the expulsion of the placenta and uterine contents to 6 to 8 weeks after birth or whenever uterus regains its prenatal shape

A

peurperium

45
Q

Changes to postpartum uterus back to prepregnancy because of:

A

withdrawal of pregnancy-induced hormones

46
Q

Discontinuance of lactation results in:

A

resumption of ovulation and menstruation

47
Q

The uterus returns back to the pelvic area between the _____ and ____ within _____ of delivery

A

pubic symphysis
umbilicus
1 week

48
Q

Heavier pressure compresses the uterus resulting in:

A

thinning of the AP diameter
increasing transverse diameter

49
Q

It is common to image the internal os on day ___ as partially open and ill-defined as it continues to close following delivery

A

1

50
Q

The myometrium should measure __-__ cm in thickness

A

7-10

51
Q

The endometrium can measure up to ___mm

A

13

52
Q

The endometrium will decrease to normal thickness by:

A

end of postpartum period

53
Q

It is common to visualize free fluid within the endometrium though it should not measure greater than ___-____ cm.

A

1.2
1.4

54
Q

The sagittal postpartum uterus will measure between __ and ___ cm

A

14
25

55
Q

The transverse postpartum uterus will measure between __ and ___ cm

A

7
14

56
Q

The _____ are typically flaccid immediately following delivery and usually return to pregravid state within one month.

A

adnexal ligaments

57
Q

Postpartum hemmorrhage limits vaginal and csection

A

vaginal 500 mL
csection 1000mL

58
Q

most common causes of postpartum hemorrhage include

A

placenta accreta
placenta increta
placenta percreta

59
Q

Placenta accreta, increta, percreta are due to:

A

complete or partial absence of the decidua basalis

60
Q

occurs when placenta adheres to myometrium of uterus instead of endometrium

A

placenta accreta

61
Q

occurs when placenta invades myometrium of uterus further than is seen with accreta

A

placenta increta

62
Q

occurs when placenta completely penetrates uterine myometrium and extends into uterine serosa

A

placenta percreta

63
Q

indicators of placental invasion of the myometrium

A

placental lakes

64
Q

through to be caused by atypical blood flow because of abnormal decidual basalis

A

placental lakes

65
Q

severe bleeding immediately following delivery

A

acute hemorrhage

66
Q

Acute hemorrhage usually results in:

A

emergency hysterectomy

67
Q

bleeding that occurs over several days to a few weeks in postpartum period

A

delayed hemorrhage

68
Q

Hemorrhage is associated with:

A

decreased hematocit
hypotension
hysterectomy
renal failure
shock
sometimes death

69
Q

any infection in the postpartum period characterized by a temperature over 100.4 degrees on any two successive days after first 24 hours postpartum

A

puerperal infection

70
Q

signs/symptoms of puerperal infection:

A

uterine tenderness
chills
headache
malaise
anorexia
lochia or vaginal discharge

71
Q

Most puerperal infections are:

A

urinary tract infections

72
Q

infection of the endometrium

A

endometritis

73
Q

usually caused by migration of normal vaginal flora

A

endometritis

74
Q

thick, irregular endometrium that may have fluid in the endometrial canal

A

endometritis

75
Q

incomplete expulsion of miscellaneous products of conception during labor and delivery

A

RPOC

76
Q

highly echogenic mass in the endometrial canal, placental polyp, remnants of placental tissue, heterogeneous mass may contain necrotic tissue, clot, or infection, affects about 1% of term deliveries

A

RPOC

77
Q

one of the most frequent causes of puerperineal infection

A

uterine atony

78
Q

uterus fails to reach pregravid tone and becomes flaccid and unable to hold its shape

A

uterine atony

79
Q

natural reaction to bleeding

A

clot

80
Q

inflammation of a vein caused by a thrombus found in lumen of vessel

A

thrombophlebitis

81
Q

rare condition found typically in postpartum period, but can also occur with malignancies and PID

A

thrombophlebitis

82
Q

hypercoagualability of blood during pregnancy and postpartum period
venous stasis
venous wall damage as a result of uterus expansion and contraction

A

Virchow’s triad

83
Q

Majority of thrombophlebitis involves:

A

right ovarian vein

84
Q

______ flow in the left ovarian vein reduces spread of infection from uterus

A

retrograde

85
Q

During the postpartum period, body decreases blood production, resulting in _____

A

venous stasis

86
Q

Thrombophlebitis symptoms typically occur during the first __-__ hours following delivery

A

48
96

87
Q

dilated anechoic to hypoechoic tubular structure extending superiorly from adnexa, lack of color or spectral Doppler signal, echogenic thrombus in lumen

A

thrombophlebitis

88
Q

Most common site for thrombophlebitis

A

where IVC and right ovarian vein meet

89
Q

common csection complications

A

hematoma
abscess

90
Q

peritoneum between urinary bladder and uterus

A

bladder flap

91
Q

site of most hematomes

A

bladder flap

92
Q

occur when there is bleeding at site of incision and body has not reabsorbed blood

A

hematoma

93
Q

Placenta accreta, increta, and percreta are abnormal placental penetration of the myometrium, which may lead to _____

A

postpartum bleeding

94
Q

______ is an infection of the endometrium that may extend to the myometrium and parametrial tissues

A

endometritis

95
Q

______ and endometritis have a similar sonographic appearance

A

RPOC

96
Q

Failure of the uterus to contract can lead to:

A

hemorrhage

97
Q

Postpartum ovarian vein thrombophlebitis occurs more often in the:

A

right ovarian vein

98
Q

_____ and ____ are two complications of a cesarean section

A

hematomas
infection

99
Q
A

OB 2 (17 decks)

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