glines trauma and ectopic Flashcards
What is the leading cause of mortality in pregnancy?
trauma
When in a woman’s LIFE is she most likely to get injured?
during the 3rd trimester of pregnancy; assuming a woman becomes pregnant, then on average more injuries happen during the 3rd trimester than any other time
Which group of pregnant women is the largest group that gets injured?
pregnant teens–not to be insensitive but probably b/c they are the most careless
Major trauma (i.e. life-threatening to MOM) are associated with a _____% fetal loss whereas minor trauma is associated with a ____ % fetal loss
4-50 %; 1-5%
Do most fetal losses result from major or minor trauma?
minor trauma, because they are more common; however, a major trauma is more likely to kill than a minor trauma
The presence of this hormone in pregnancy may be responsible for trauma
relaxin, it loosens the joints to the point of possible instability = fall
What is true of the frequency of domestic violence in pregnant vs. non pregnant women?
domestic violence is increased in pregnancy for many reasons; thus, it is an important cause of trauma of pregnancy
The majority of trauma centers see (choose blunt or penetrating) trauma 70% of the time and it is usually caused by _____
blunt; motor vehicle accidents
What are the top 3 causes of blunt trauma
1) MVA 2) falling especially after 20 weeks (big belly + relaxin = fall) 3) domestic violence
Why might a pregnant woman be more likely to die of a MVA than a nonpregnant woman?
a pregnant woman is less likely to wear a seatbelt because of her belly; 1/3 to 1/2 don?t wear them or don?t wear them correctly
These are very likely TQ’s: in trauma (i.e. MVA) the most common cause of MATERNAL DEATH is ___________ whereas the most common cause of fetal death is __________. The second most common cause of fetal death is ____________
Head injury to mom = #1? Maternal shock is most likely cause of death in fetus; second most likely cause in trauma situation is placental abruption
T/F many fetuses (feti?) die of direct head trauma
false, direct head trauma = <1% of fetal death
What physical properties of the placenta and myometrium allow for shearing in MVA which causes placental abruption
The differences in elasticity, placenta is inelastic and myometrium is elastic
T/F: the risk of placental abruption increases with abberant implantation of the blastocyst, i.e. placenta previa
False, the rates of placental abruption are independent of the location of the placenta in the uterus
A woman presenting to the office with a firm abdomen that has unrelenting pain, hypertonicity and dark blood coming out of her vagina likely has ____________
placental abruption
When do most falls in pregnant women occur?
after 20 weeks
This is the second most common type of blunt injury
falls
What is the classic presentation of placental abruption?
hard abdomen, persistent pain, hypertonicity, and dark vaginal bleeding
T/F: we have a terrible relationship but if we have a kid, things will get better, they’re so cute!
false, women who report domestic abuse when non-pregnant report increased rates of domestic abuse when pregnant
Domestic abuse is the ______ most common cause of blunt trauma in pregnancy
3rd
What is the most likely cause of penetrating trauma in pregnancy?
gunshot wounds > stabbing
Why is it unlikely that a pregnant woman stabbed in the first 12 weeks would suffer DIRECT injury to the fetus?
The fetus is protected by the bony pelvis during the first 12 weeks; however, the risk for maternal shock is still the same and that is a common cause of fetal death
Why are pregnant women who are stabbed less likely to suffer a lower GI injury than nonpregnant?
because lower GI organs are pushed out of the way by the gravid uterus
What is the total increase in blood volume in most women?
40-45%
Why do pregnant women suffer from physiologic anemia?
because they have increased volume but no increase in RBC mass (there is no decrease in RBC’s, just dilution)
