Obstetric hemorrhage & puerperal sepsis

Question 1

Packet RBC (PRBC) in antepartum hemorrhage. 1 unit (?-?) & will raise the Hct by ?%

Answer 1

(250-300cc) and Hct by 3%

Question 2

what is painless cervical dilation

Answer 2

cervical insufficeincy

Question 3

what presents classically as painless vaginal bleeding? cervical insufficiency, placental previa,placental abruption

Answer 3

placental previa

Question 4

wat is the most common type of abnormal placentation?

Answer 4

placental previa

-note the most common type of the 3rd trimester is placental abruption

Question 5

Characterized by the encroachment of the placenta to the margin of the cervical os. DOES NOT cover the os? what type of placental previa? Marginal, partial, complete

Answer 5

marginal

Question 6

what type of placental previa is partial occlusion of the cervical os by the placenta? Marginal, partial, complete

Answer 6

partial

Question 7

what type of placental previa is that the cervical os is completely covered by the placenta. Plus its the most serious type & is associated with greater blood loss? Marginal, partial, complete

Answer 7

complete

Question 8

what is the most common form of abnormal placental implantation. It is an abnormal firm attachment to the myometrium? Placenta accreta, placenta increta, placenta percreta

Answer 8

placenta accreta

Question 9

what abnormal placental implantation invades the myometrium? placenta accreta, placenta increta, placenta percreta

Answer 9

placenta increta

Question 10

what abnormal placental implantation is through the myometrium into the uterine serosa and is the least common? placenta accreta, placenta increta, placenta percreta

Answer 10

placenta percreta

Question 11

what is the most common cause of the third trimester bleeding

Answer 11

placental abruption

• note this has painful bleeding
• cocaine use can be a risk factor

Question 12

what is the most common cause of DIC in pregnancy

Answer 12

placental abruption

Question 13

what is the most common risk factor for uterine rupture? prior uterine incision, trauma, multiparity

Answer 13

prior uterine incision

Question 14

who has a high recurrence rate of uterine rupture? lower uterine segment rupture or upper segment uterine rupture

Answer 14

upper segment uterine rupture

Question 15

what trimester bleeding is associated with rupture of the fetal vessel, which is often secondary to velamentous insertion of the umbilical cord

Answer 15

vasa previa

Question 16

when vessels rupture often acute vaginal bleeding is noted w/ a change in feral HR. what is happens first tachycardia or bradycardia

Answer 16

initial tachycardia followed by bradycardia

Question 17

third trimester fetal bleeding. which one is associated with lost of whartons jelly? velamentous cord insertion or vasa previa

Answer 17

velamentous cord insertion

-note vasa previa is the rupture of fetal vessel

Question 18

what is the most common cause of postpartum hemorrhage

Answer 18

uterine atony

-note this is primary postpartum hemorrhage

Question 19

presence of lactobacilli causes acid or alkaline environment

Answer 19

acid

Question 20

after delivery, the pH of the vagina becomes more? acidic or alkaline

Answer 20

alkaline

-which attracts aerobic organisms

Question 21

about 48 hours after delivery the endometrial and placental remnants produce a favorable intrauterine environment for the production of what kind of bacteria

Answer 21

Anaerobic

-note these account for about 70% of puerperal infections. He FOCUSED ON THIS

Question 22

what medications are seen in puerperal sepsis

Answer 22

Ampicillin + Gentamicin and use Clindamycin if really resistant kind of bug

Question 23

Ovarian vein thrombophlebitis or deep septic pelvic vein thrombophlebitis. which one appears clinically ill

Answer 23

ovarian vein thrombophlebitis

Question 24

what usually has unlocalized fever in the first few days that is non responsive to antibiotics? ovarian vein thrombophlebitis or deep septic pelvic vein thrombophlebitis

Answer 24

deep septic pelvic vein thrombophlebitis

Question 25

women after surgery presents with atelectasis, UTI, wounds..what does she have

Answer 25

septic pelvic thrombophlebitis