Module 2 Unit A

Question 1

What are the risk factors for placenta previa?

Answer 1

Hx of placenta previa
multiple gestation (twin, triplet….etc)
uterus surgery
maternal age
smoking
cocaine use
prior suction and currettage
hx of c-section

Question 2

How might placenta previa present

Answer 2

bright red painless vaginal bleeding
pelvic pain

via U/S…if found early on u/s, repeat ultrasound at 28 weeks it usually resolves.

Question 3

How does placenta previa fit in the differential diagnoses of vaginal bleeding during pregnancy

Answer 3

First - 2nd trimester:
subchorionic hematoma
cervicitis
cervical cancer
threatened abortion
ectopic pregnancy
molar pregnancy

Third trimester:
labor
placental abruption
vasa previa
placenta previa

Question 4

What are the different variations of placenta previa..eg. complete, etc

Answer 4

Complete….completely covers cervical os
Partial….partially covers cervical os
Marginal…near the edge of the cervical os

Question 5

What are the components of a management plan for a pregnant individual with placental previa

Answer 5

Continue with pelvic rest
Report any vaginal bleeding

Persistent previa requires cesarean delivery

Question 6

What are the risk factors for placental abruption

Answer 6

Trauma

Question 7

How might placental abruption present

Answer 7

Painful bright red vaginal bleeding.
Abdominal pain
back pain uterine contraction….no relief
Dizziness
Decreased fetal movement

Question 8

what are the differential diagnoses for those subjective and objective findings

Question 9

What are the diagnostic criteria for placental abruption

Answer 9

U/S

Question 10

what are the components of a management plan for a patient with placental abruption

Question 11

What are the risk factors for placenta accreta

Question 12

How would an obstetric care provider discover that a patient had placenta accreta

Question 13

What are the diagnostic criteria for placenta accreta

Question 14

What are the differences between placenta accreta, increta, and percreta

Question 15

When and how does a WHNP involve other members of the health care team for a pregnant patient suspected of having placenta accreta?

Question 16

Grades of placenta abruption

Answer 16

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.

Question 17

What is Vasa Previa

Answer 17

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.

Question 18

Types of Placenta abruption

Answer 18

1. Concealed abruption…..when there is only a small accumulation of blood and it’s hidden behind the placenta….no vaginal bleeding
2. Complete abruption ..when the blood has torn through the entire seal and the placenta is completely separated from the uterus