NBME 10. 145Q. placenta previa 02-18 (1)

Question 1

CP of placenta previa. best next step in Mx?

Answer 1

PELVIC UG (vs immediate s/c)

Question 2

when pelvic UG? case

Answer 2

CP are present + need UG TO MAKE A DIAGNOSIS

When Dx is made –> tada daryti s/c

Question 3

Common presenting symptom?

Answer 3

third trimester painless vaginal bleeding.

Question 4

Risk factors for placenta previa?

Answer 4

include causes of uterine scarring, such as multiparity, previous cesarean delivery, and prior dilation and curettage.

Question 5

When detected early, the condition often …..

Answer 5

self- resolves as the pregnancy progresses and the placenta migrates away from the os.
iki 36 sav gali migruoti

Question 6

However, if placenta previa persists into the third trimester and to the time of labor,……. Mx?

Answer 6

cesarean delivery is indicated to prevent significant hemorrhage, maternal/fetal complications, and potential fetal demise

Question 7

Avoid what?

Answer 7

avoid digital cervical examination, because it can disrupt the placental bed and cause significant hemorrhage.

Question 8

First step in evaluation?

Answer 8

ultrasonography!!!

avoid digital examination!!!

Question 9

Immediate cesarean delivery (Choice D) should not be pursued until…….?????

Answer 9

l the diagnosis is confirmed.

!!!!!! its presence should first be confirmed with pelvic ultrasonography –> just then S/c.

Question 10

kiti variantai. Apt test (Choice A) is a test used to …..?

Answer 10

differentiate maternal blood from fetal blood when the source is unclear.

Question 11

kiti variantai. Apt test.
It is most commonly used to evaluate ….. and ….

Answer 11

maternal vaginal blood

blood in fetal stool or emesis.

Question 12

kiti variantai. Apt test. also can be used to evaluate vaginal bleeding during ….

Answer 12

pregnancy, but use is limited in the evaluation of placenta or vasa previa since the mother and fetus may decompensate before the test results.

Question 13

kiti variantai. Contraction stress test (Choice B) is used to evaluate ……..?

how is done?

Answer 13

fetal response to stress and is done by inducing contractions in a mother and then monitoring the fetal heart rate.

Question 14

kiti variantai. Contraction stress test.
It is commonly used in pregnancies that are complicated by conditions that put the fetus at increased risk for ….? name conditions.

Answer 14

hypoxemia, such as maternal diabetes or preeclampsia

Question 15

kiti variantai. Contraction stress test. It is contraindicated in what 2 conditions?

why?

Answer 15

in placenta or vasa previa, since contractions can lead to worsening fetomaternal hemorrhage.