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Repro 2 Final AH > Hemorrhage And Sepsis - Moulton > Flashcards

Hemorrhage And Sepsis - Moulton Flashcards

1
Q

When do you deliver baby w/placenta previa?

A

36-37 weeks, do not want her to go into labor

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2
Q

Crypercipitate has what effect?

A

Inc fibrinogen by 10 mg/dL

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4
Q

Deep septic Vein thrombophlebitis fever?

Clinical presentation?

Diagnose how?

A

Unlocalized fever non-responsive to Abs in first few days

Do NOT appear clinical ill

No radiograph, dx of exclusion

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5
Q

What surgical tx used for uterine hemorrhage?

A

O’Leary stitch - ligation of uterine a.

B-Lynch suture

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6
Q

Tx septic pelvic thrombophlebitis?

Specifically tx ovarian vein thrombosis?

A

UF Heparin or LMW heparin

Anticoagulate 6 weeks, repeat imaging

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9
Q

Most common reasons for placental abruption?

Most common cause of what?

A

Cocaine use
Car wreck
HTN

DIC

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11
Q

How to treat puerperal sepsis?

What is the major Ab-resistant pathogen?

A

Ampicillin
Gentamicin
Clindamycin

Bacteroides fragilis

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12
Q

Risk of uterine rupture w/low transverse uterine incision?

Classic vertical?

A

1%

4-7& –> must do c section

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13
Q

Oxytocin CI in whom?

Dinoprostone (PGE2)?

A

Undiluted rapid IV infusion

Pt hypotensive

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14
Q

FFP has what effect?

A

Inc. fibrinogen by 10 mg/dL

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18
Q

Unprotected vessels that pass over the cervical os is called what?

A

Vasa previa - inc mortality rate

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19
Q

Platelets have what effect?

A

Inc platelet count by 5-10,000

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22
Q

What is associated w/copious bleeding and hypovolemic shock?

A

Uterine inversion

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24
Q

Secondary hemorrhage occurs when?

Due to what?

A

24 hours to 12 weeks

Subinvolution of uterus, sloughing of the Escher or retained POC

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26
Q

Invades the myometrium is what?

A

Placenta increta

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27
Q

How to diagnose placenta previa?

Mean gestational age when bleeding occurs?

A

US

30 weeks

28
Q

Methylergonovine is CI in whom?

15-methyl PGF2a?

A

HTN pt

Asthma pt

31
Q

What is defined as temp > 100.4 (38) that occurs for more than 2 consecutive days during first 10 postpartum days?

A

Febrile morbidity - puerperal sepsis

32
Q

After delivery the pH becomes what?

A

More alkaline

33
Q

Primary hemorrhage occurs when?

Due to what?

A

W/in 24 hours

Uterine atony

34
Q

Ovarian Vein Thrombophlebitis fever present?

Cx presentation?

Dx how?

A

Fever and ABD pain w/1 week after delivery

Appear clinically ill

20% seen on radiograph

35
Q

Vaginal bleeding before 20 weeks and painless dilation indicates?

A

Cervical insufficiency

36
Q

Tx for uterine atony?

A 
Bimanual massage
Oxytocin
Methylergonovine
15-Methyl PGF2
Dino/Mist
37
Q

What is assoc w/extravasation of blood into the uterus?

A

Couvelaire uterus

41
Q

Boggy uterus means what?

A

Uterine atony –> PPH

42
Q

Placenta previa is what?

Presents how?

A

Implantation of placenta over cervical os (most common abnormality)

Painless vaginal bleeding

43
Q

Postpartum hemorrhage (PPH) defined how after vaginal birth?

C section?

A

> 500 cc

> 1000 cc

44
Q

Packed red cells have what effect?

A

Inc Hct by 3%, Hb by 1 g/dL

47
Q

What is defined as premature separation of the normally implanted placenta?

A

Placental abruption

48
Q

Management of uterine rupture?

If large?

A

Laparotomy and deliver baby

Cesarean hysterectomy

49
Q

What presents as painful bleeding, uterine tenderness, uterine hyperactivity, and fetal distress/death?

A

Abruptio placenta

51
Q

3 types of placenta previa?

A

Marginal - does not cover os
Partial
Complete

53
Q

What is causing sudden onset of intense abdominal pain w/or w/out vaginal bleeding, abnormal FHR or palpation of fetal parts?

A

Uterine rupture

56
Q

What causes 3 trimester bleeding?

A

Fetal vessel rupture secondary to velamentous insertion of umbilical cord

62
Q

Thought the myometrium into the uterine serosa is what?

A

Placenta percreta

67
Q

Abnormal firm attachment to the superficial lining of the myometrium is what?

A

Placenta accreta

Repro 2 Final AH (9 decks)

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