Module 07: Premature Cervical Dilation, Placenta Previa, and Abruptio Placenta Flashcards
Under this complication, the cervix dilates prematurely and cannot hold the fetus until term.
Premature Cervical Dilatation or Incompetent Cervix
Incompetent cervix is characterized as what
Painless cervical effacement and dilatation in early mid t-trimester resulting to the expulsion of products of conception.
Premature cervical dilatation is also known as the most common cause of what?
HABITUAL ABORTION
What are the risk factors for premature cervical dilatation?
(A) Increased maternal age
(B) Congenital structural defects
(C) Trauma to the cervix
(D) Repeated D&C
What are the signs and symptoms of incompetent cervix?
(A) Pink stained vaginal discharge or bloody show
(B) Increased pelvic pressure
(C) PROM
(D) Contractions mid trimester
(E) Presence of painless cervical dilatation
What is the surgical management of incompetent cervix?
CERVICAL CERCLAGE (Purse string sutures are placed in the cervix by the vaginal route
under regional anesthesia)
What are the two types cervical cerclage?
(A) SHIRODKAR
(B) MCDONALD
When is cervical cerclage done?
14 to 16 weeks of gestation
What is the goal of cervical cerclage?
To strengthen the cervix and prevent it from dilating.
Under this type of cervical cerclage, nylon sutures are placed horizontally and vertically across the cervix and pulled tight to reduce the cervical canal to a few millimeters in.
MCDONALD’S (TEMPORARY)
Under this type of cervical cerclage, Sterile tape is the threaded in a purse-string manner under the submucosal layer of the cervix and sutures in place to
achieve a closed cervix.
SHIRODKAR (PERMANENT)
What is the nursing management after cerclage?
(A) Place the woman in bed rest for 24 hours.
(B) Observe for bleeding, uterine contractions, and rupture of BOW.
(C) If BOW ruptures, sutures are removed.
(D) If uterine contractions occur, give ritodine to stop.
(E) Restrict activities, including coitus, for two weeks.
(F) Place in slight or modified trendelenburg position.
What are the two types of third trimester bleeding?
(A) Placenta Previa
(B) Abruptio Placenta
The placenta is found in the posterior part of the uterus.
What is the normal weight of the placenta?
500 GRAMS
What is the normal diameter of the placenta?
15 to 20 CM
What is the normal thickness of the placenta?
1.5 to 3.0 cm
The placenta weighs approximately what fraction of the fetus’s weight?
1/6th
What is the normal number of cotyledons in the placenta?
15 to 28
This type of bleeding is characterized as the abnormal implantation of placenta in the lower uterine
segment, partially or completely covering the internal cervical os.
PLACENTA PREVIA (multiple pregnancy and gestational diabetes can be one of the roots of this)
What are the symptoms of placenta previa based on the case studied?
(A) Bright red vaginal bleeding
(B) Spotting
(C) Non-tender abdomen
Under this type of placental implantation, the placenta completely covers the cervix.
Top Placenta Previa (Complete)
In top placenta previa, is normal vaginal delivery possible? YES OR NO?
NO (When the placenta comes out first, the oxygen supply is then cut off leading to fetal hypoxia)
Under this type of placental implantation, the placenta is partially over the cervix.
Partial Placenta Previa
In partial placenta previa, is normal vaginal delivery possible? YES OR NO?
Normal vaginal delivery is not possible since a part of the placenta still blocks the cervix.