Module 2 Unit A Flashcards
What are the risk factors for placenta previa?
Hx of placenta previa
multiple gestation (twin, triplet….etc)
uterus surgery
maternal age
smoking
cocaine use
prior suction and currettage
hx of c-section
How might placenta previa present
bright red painless vaginal bleeding
pelvic pain
via U/S…if found early on u/s, repeat ultrasound at 28 weeks it usually resolves.
How does placenta previa fit in the differential diagnoses of vaginal bleeding during pregnancy
First - 2nd trimester:
subchorionic hematoma
cervicitis
cervical cancer
threatened abortion
ectopic pregnancy
molar pregnancy
Third trimester:
labor
placental abruption
vasa previa
placenta previa
What are the different variations of placenta previa..eg. complete, etc
Complete….completely covers cervical os
Partial….partially covers cervical os
Marginal…near the edge of the cervical os
What are the components of a management plan for a pregnant individual with placental previa
Continue with pelvic rest
Report any vaginal bleeding
Persistent previa requires cesarean delivery
What are the risk factors for placental abruption
Trauma
How might placental abruption present
Painful bright red vaginal bleeding.
Abdominal pain
back pain uterine contraction….no relief
Dizziness
Decreased fetal movement
what are the differential diagnoses for those subjective and objective findings
What are the diagnostic criteria for placental abruption
U/S
what are the components of a management plan for a patient with placental abruption
What are the risk factors for placenta accreta
How would an obstetric care provider discover that a patient had placenta accreta
What are the diagnostic criteria for placenta accreta
What are the differences between placenta accreta, increta, and percreta
When and how does a WHNP involve other members of the health care team for a pregnant patient suspected of having placenta accreta?
Grades of placenta abruption
Grade 1: some small amount of vaginal bleeding and uterine contraction…but no signs of fetal distress or low blood pressure in the mother
Grade 2: Mild to medium amount of bleeding and uterine contraction. The baby’s heart rate may show signs of distress.
Grade 3d: Medium to severe bleeding or hidden bleeding. Also uterine contraction that don’t relax, belly pain, low blood pressure and the death of the baby.
Sometimes placental abruption isn’t fount until after delivery when an area of clotted blood is found behind the placenta.
What is Vasa Previa
when the vessels within the umbilical cord lie across the cervical os.
The cord can be torn whenever the cervix dilates or when the membranes rupture.
Types of Placenta abruption
- Concealed abruption…..when there is only a small accumulation of blood and it’s hidden behind the placenta….no vaginal bleeding
- Complete abruption ..when the blood has torn through the entire seal and the placenta is completely separated from the uterus
