Late Pregnancy Bleeding

Question 1

define late pregnancy bleeding…

Answer 1

vaginal bleeding after 20 wks

Question 2

management of late bleeding in pregnancy..

Answer 2

CBC, DIC workup, type + cross + match, Sonogram! (NEVER PERFORM A DIGITAL OR SPECULUM EXAM UNTILL U/S RULES OUT PLACENTA PREVIA), large bore IV w/NS, Urinary Catheter

Question 3

Abruptio Placenta

dx? tx?

Answer 3

normally implanted placenta separates from the uterine wall before delivery of the fetus. dx w/U/S. tx: C-section, vaginal delivery >36 wks, conservative if stable

Question 4

Placenta Previa

dx? tx?

Answer 4

placenta is implanted in the lower uterine segment. dx w/U/S. tx: tx: C-section, vaginal delivery if less than 2cm covering os, conservative if stable then planned C-section

Question 5

Placenta Accreta vs Placenta Increta vs Placenta Percreta

Answer 5

Placenta Accreta = villi invader the deeper layers of the endometrial deciduus basalis but do not penitrate myometrium.
Placenta Increta = villi invade myometrium
Placenta Percreta = villi invade all teh way to the uterine serosa or the bladder

Question 6

Placenta Accreta

Answer 6

Placenta Accreta = villi invader the deeper layers of the endometrial deciduus basalis but do not penitrate myometrium.

Question 7

Placenta Increta

Answer 7

Placenta Increta = villi invade myometrium

Question 8

Placenta Percreta

Answer 8

Placenta Percreta = villi invade all teh way to the uterine serosa or the bladder

Question 9

Vasa Previa

Answer 9

fetal vessels transcerse over Os.

classic triad: rupture of membranes, painless vaginal bleeding, fetal bradycardia

Question 10

Uterine Rupture

dx? tx?

Answer 10

vaginal bleeding, loss of electronic fetal HR, ab pain, loss of station of fetal head. dx: surgical exploration, tx w/ immediate delivery