Obgyn Flashcards
What is placental abruption?
The premature separation of the placenta from the uterus.
It is a serious condition that can lead to complications for both the mother and fetus.
List some associated risk factors for placental abruption.
- Previous abruption
- Smokers
- After caesarean section
- Multiple pregnancy
- Thrombophilia
- Increasing age
- High parity
- Low socio-economic status
These factors may increase the likelihood of experiencing placental abruption.
What are typical presentations of placental abruption?
- Bleeding
- Tender tense uterus
- Fetal distress
20% of abruptions may have concealed hemorrhage, so absence of vaginal bleeding does not exclude the diagnosis.
When should placental abruption be considered?
Whenever bleeding is encountered in the second half of pregnancy.
Early recognition is crucial for management.
Define placenta praevia.
Implantation of the placenta over the internal cervical os.
It can lead to complications during delivery.
What are the different variants of placenta praevia?
- Complete placenta praevia
- Partial placenta praevia
- Marginal placenta praevia
Each variant describes the degree of coverage of the cervical os by the placenta.
What is a low-lying placenta?
A placenta that implants in the caudad one half to one third of the uterus or within 2-3 cm from the os.
It may lead to bleeding and complications during labor.
List some conditions associated with placenta praevia.
- Large placenta (e.g. twins)
- Uterine abnormalities
- Fibroids
- Multiparity
- Former surgery (e.g. caesarean section)
- Previous infection
These conditions can increase the likelihood of placenta praevia.
What is the classic presentation of placenta praevia?
Painless vaginal bleeding with the amount of visible blood loss in keeping with the physiological status of the patient.
This differentiates it from other causes of bleeding in pregnancy.
Define vasa praevia.
Foetal vessels crossing or running in close proximity to the inner cervical os.
This condition poses significant risks to the fetus during labor.
What is the risk associated with vasa praevia?
Significant risk of foetal exsanguination if vessels are torn when membranes rupture, with a 50-75% foetal mortality rate.
Early detection is critical for preventing fatal outcomes.
What symptom is highly suggestive of vasa praevia?
Antepartum haemorrhage immediately after artificial rupture of the membranes.
This symptom requires immediate medical assessment.
