deck_5527472 Flashcards
What is a bloody show?
Cervical dilation during normal labor is commonly accompanied by a small amount of blood or blood-tinged mucus
T or F. Digital examination should be done to diagnose third trimester bleeding until ultasound excludes a placenta previa
T. However, a steril speculum exam can be performedbefore ultrasound
What test can be performed to calculate the appropriate dose of Rhogam to give to a Rh- mother at 28 weeks gestation?
Kleihauer-Betke test
What is placenta previa?
This is when the palcenta implants into the decidua near or overlying the internal cervical os
What things increase the risk of placenta previa?
age, smoking, and previous C-sections
Describe the prevelance and normal progression of placenta previa
They are a common incidental finding in a second trimester ultrasound but he vast majority regress by birth
T or F. A tranvaginal ultrasound is safe in a suspected placenta previa
T.
Why does placenta previa tend to resolve spontanoeusly so commonly?
Due to growth of the placental trophoblasts toward the fundus, with its richer blood supple and the development or elongation of the lower uterine segment
How does symptomatic placenta previa typically present?
vaginal, painlessbleeding in the late second or third trimester, often after sexual intercourseNOTE: this bleeding is not usually sufficient to hurt the mother or the fetus
Most neonatal morbidity and mortality associated with placenta previa results from what?
complications of prematurity (so the main therapeutic strategy for placenta previa is to prolong the pregnancy until fetal lung maturity is achieved, typically via the use of tocolytic agents or cervical creclage)
The likelihood of a previa persising until term increases if the previa is _________
complete, or presents initially at a later gestaitional age, or if there is a Hx of C-section
T or F. The length of placental to internal cervical os overlap is highly correlated to the risk of previa presistence to term
T.
Women with asymptomatic previa in the second trimester can continue normal activities until follow-up ultasound is performed at 28 weeks and women with persistent previa in the third trimester should report any bleeding and abstain from intercourse and use of tampons
Becuase previa can resolve close to erm, its reccommendd that no decision on mode of delivery be made until after ultrasound at 36 weeks
Note that the closer a persistent previa is the internal cervical os, the more likely that a C-section will likely have to be performed
T or F. The risks for placenta accreta, increta, and percreta increase with increased number of previous C-sections
T.
