Exam 3 Abn Preggo 3 Flashcards
Placenta Previa is?
Cause?
Placenta near or over cervical os
Most C cause of 3rd tri bleeding
Unclear
Placenta Previa risk factors? (4)
Multiples
Old mom
Smoking/Cocaine
Hx of C-Sec or uterine surgery
Placenta Previa: Complete?
Partial?
Marginal?
Low-lying?
os completely covered
os partially covered
edge at margin of os
near but doesn’t reach os
Placenta Previa presentation?
PAINLESS vag bleed in late 2nd or 3rd tri
Placenta Previa diagnostics?
Transabdominal US -> confirm w/ TVUS
Placenta Previa mgmt? (3)
NEVER do bimanual/cervical exam!
Preterm w/o active bleed: corticos < 34 wks, C-Sec at 37 wks
Spont labor or hemorr: immediate C-Sec
Placenta Previa complications?
Preterm delivery/death
Other placental issues
Abruptio Placentae is?
Abn premature separation of otherwise normal placenta
Complete, partial or marginal separation
Abruptio Placentae risk factors? (6)
Multiples Old mom Smoking/Cocaine/Meth Thrombophilias Prior abortion Abdominal trauma
Abruptio Placentae presentation? (5)
2nd/3rd tri bleed Hemorr + abd pain most C Fetal distress Rigid abdomen DIC
Abruptio Placentae mgmt? (3)
Stabilize
Deliver if fetus distressed
Corticos <34 wks
Vasa Previa is?
Fetal bv run through membranes b/w baby and cervix
Membrane rupture = fetal bv rupture and death
Vasa Previa risk factors? (4)
Multiples
2nd tri low-lying placenta
Bi-lobed placenta
InVitro preggo
Vasa Previa presentation?
Diagnostics?
Vag bleed w/ memb rupture and specific fetal heart changes
Color Doppler US
Vasa Previa mgmt? (3)
Inpt 3rd tri
Corticos < 34 wks
C-Sec @ 35 wks
Premature Rupture of Membranes (PROM) is?
Why do we care?
Rupture before labor
Risk of preterm labor, prolapsed cord, placenta separation, uterine infection
PROM risk factors? (6)
SMOKING Prior PROM Short cervix Prior preterm Multiples Polyhydramnios (excess amniotic fluid)
PROM confirmation? (3)
Confirm fluid is amniotic (pH test)
Fetal lung maturity
Avoid vag exam
PROM mgmt? (3)
> 34 wks -> induce
24-34 wks -> inpt steroids/ABX/Mg
+ chorioamnionitis (bacterial inf of fetal memb) = prompt delivery
Postterm Labor is?
Why do we care? (2)
Pregnancy 42+ wks
Risk of Stillbirth, Fetal dysmaturity synd (malnutrition)
Postterm Labor risk factors? (6)
Nulliparity Previous postterm Male baby Fetal anecephaly Obese mom Old mom
Postterm Labor mgmt? (3)
Induce at 41 wks
Serial NST/BPP
Fetal kick counts daily
