OnlineMedEd: Obstetrics - "3rd Trimester Bleeding" Flashcards
What is bloody show?
Vaginal bleeding that occurs with rupture of membranes
There are three kinds of third trimester bleedings that are benign: _________________.
- Cervical lesions
- Cervical dilation
- Bloody show
How should you initially assess third trimester bleeding?
- Evaluate the mom: vitals, hct/hgb, CBC
- Evaluate the baby: NST, ST, FHT
If either looks worrisome, then induce labor or do a c-section.
How can pain be helpful in diagnosing third trimester bleeding?
- If the bleeding is painful, then it is likely from the uterus –meaning uterine rupture.
- If the bleeding is painless, then it is likely from the placenta (possibly previa).
______________ can cauase placenta previa.
Insufficient blood flow to the placenta (because it needs to search wider to get more blood)
How does placenta previa lead to painless bleeding?
When the cervix dilates, it can stretch the placenta and cause tearing.
What are the three grades of placenta previa?
- Marginal
- Partial
- Complete
Describe vasa previa.
In vasa previa, there is an accessory lobe of the placenta that is on the other side of the cervical os. Blood vessels span the os to the other side. When these rupture, third trimester bleeding can result.
Other than pain, what aspect of the history can help you diagnose uterine rupture?
Contractions!
Women need to be having contractions in order to have uterine rupture, so if there are no contractions then it is unlikely to be rupture.
Loss of fetal station indicates _____________.
uterine rupture (go for the crash section)
Describe complete and contained placental abruptions.
- Complete: an edge of the placenta breaks off and blood flows out
- Contained: the center of the placenta breaks off and blood is contained in a pocket of the placenta
What causes placental abruption?
- Trauma
- HTN
- Cocaine use (another form of HTN)
