Placenta Accreta/Uterine Rupture

Question 1

What is?

Answer 1

Morbidly adherent placenta

Question 2

Cause of placenta accreta?

Answer 2

Increasing risks with multiple C sections
Assoc with severe bleeding. PPH, hysterectomy
Major risk factors: placenta praevia, prior C sect

Question 3

Managemnet?

Answer 3

Prophylactic internal iliac artery balloon
Caesarean hysterectomy
Blood loss > 3L expected
Conserv management +plus methotrexate ?

Question 4

What is uterine rupture?

Answer 4

Full thickness opening of uterus

Incudes serosa

Question 5

Cuse of uterine rupture?

Answer 5

Multiparity
Obstructed labour
Prev C section

Question 6

Presentation of uterine rupture?

Answer 6

Severe abdo pain 
Shoulder tip pain 
Maternal collapse 
PV bleeding 
Intra-partum loss of contractions 
Acute abdom 
PP rises 
Peritonism 
Foetal distress/IUD

Question 7

Management of uterine rupture?

Answer 7

Urgent resus and surgical managemnet 
2 large bore IV access 
FBC, clotting, LFT, U&Es 
IV fluids etc 
Anti D?