Obstetric hemorrhage & puerperal sepsis Flashcards
Packet RBC (PRBC) in antepartum hemorrhage. 1 unit (?-?) & will raise the Hct by ?%
(250-300cc) and Hct by 3%
what is painless cervical dilation
cervical insufficeincy
what presents classically as painless vaginal bleeding? cervical insufficiency, placental previa,placental abruption
placental previa
wat is the most common type of abnormal placentation?
placental previa
-note the most common type of the 3rd trimester is placental abruption
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
marginal
what type of placental previa is partial occlusion of the cervical os by the placenta? Marginal, partial, complete
partial
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
complete
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
placenta accreta
what abnormal placental implantation invades the myometrium? placenta accreta, placenta increta, placenta percreta
placenta increta
what abnormal placental implantation is through the myometrium into the uterine serosa and is the least common? placenta accreta, placenta increta, placenta percreta
placenta percreta
what is the most common cause of the third trimester bleeding
placental abruption
- note this has painful bleeding
- cocaine use can be a risk factor
what is the most common cause of DIC in pregnancy
placental abruption
what is the most common risk factor for uterine rupture? prior uterine incision, trauma, multiparity
prior uterine incision
who has a high recurrence rate of uterine rupture? lower uterine segment rupture or upper segment uterine rupture
upper segment uterine rupture
what trimester bleeding is associated with rupture of the fetal vessel, which is often secondary to velamentous insertion of the umbilical cord
vasa previa
when vessels rupture often acute vaginal bleeding is noted w/ a change in feral HR. what is happens first tachycardia or bradycardia
initial tachycardia followed by bradycardia
third trimester fetal bleeding. which one is associated with lost of whartons jelly? velamentous cord insertion or vasa previa
velamentous cord insertion
-note vasa previa is the rupture of fetal vessel
what is the most common cause of postpartum hemorrhage
uterine atony
-note this is primary postpartum hemorrhage
presence of lactobacilli causes acid or alkaline environment
acid
after delivery, the pH of the vagina becomes more? acidic or alkaline
alkaline
-which attracts aerobic organisms
about 48 hours after delivery the endometrial and placental remnants produce a favorable intrauterine environment for the production of what kind of bacteria
Anaerobic
-note these account for about 70% of puerperal infections. He FOCUSED ON THIS
what medications are seen in puerperal sepsis
Ampicillin + Gentamicin and use Clindamycin if really resistant kind of bug
Ovarian vein thrombophlebitis or deep septic pelvic vein thrombophlebitis. which one appears clinically ill
ovarian vein thrombophlebitis
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
deep septic pelvic vein thrombophlebitis
