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Systems- Repro > Placenta previa & abruption > Flashcards

Placenta previa & abruption Flashcards

1
Q

What is the definition of placenta previa

A

When the placenta implants in the lower uterine segment

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2
Q

What are the clinical features of placenta previa

A

Painless vaginal bleeding

Malpresentation of fetus

Soft & non-tender uterus

Tachycardia

Hypotension

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3
Q

What type of vaginal bleeding occurs in placenta previa

A

Painless

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4
Q

What is the main management strategy for placenta previa

A

C-section

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5
Q

What is the 1st line investigation for placenta previa

A

USS

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6
Q

What are the investigations for placenta previa

A

USS
MRI

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7
Q

What is a potential complication of placenta previa

A

Post-partum haemorrhage

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8
Q

What are the risk factors for placenta previa

A

High parity

Multiple pregnancies

Smoking

Previous C-section

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9
Q

How is placenta previa graded

A

By how much of the internal cervical os is covered

Graded from 1 -> 4

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10
Q

What are the 4 grades of placenta previa

A

Grade 1 -> ICO is not covered but placenta is low-lying

Grade 2 -> ICO is marginally covered

Grade 3 -> ICO is partially covered

Grade 4 -> ICO is completely covered

ICO= internal cervical os

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11
Q

What must you do prior to a C-section for placenta previa

A

USS

(don’t wanna do an Adam Kay bro)

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12
Q

What are the treatments for placenta previa

A

C-section

Tranexamic acid

Prostaglandin pessaries

IV oxytocin

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13
Q

What is the definition of placenta abruption

A

The seperation of the placenta from the inner uterine wall before birth, resulting in a revealed or concealed haemorrhage

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14
Q

What are the 3 different types of placenta abruption

A

Revealed

Concealed

Mixed

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15
Q

What is the difference between a revelaed and concelead placenta abruption

A

Revealed

When the haemorrhage casued by the placenta abruption escapes through the cervical os, so the haemorrhage is apparent externally

Concealed

The heamorrhage occurs between the placenta and the uterine wall

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16
Q

What are some of the signs of a concealed placenta aburption that are usually not be present in a revealed abruption

A

Increased fundal height

Increased uterine volume

17
Q

In concealed placenta aburptions, blood can sometimes penetrate the uterine wall and cause some bruising to the uterus

What is this called?

A

Coucelaire uterus

(cou-ve-laire)

18
Q

What can sometimes form in the uterus after a placenta abruption

A

A retroplacental clot

19
Q

What is the classic signs of placetna aburption

A

Heavy vaginal bleeding that is late in pregnacny

20
Q

What are the clinical features of placetna abrutpion

A

Heavy vaginal bleeding late in pregnancy

Abdominla pain

Uterine contractions & tenderness

Lower back pain

21
Q

What investigation should you always do for a placenta abruption and what would you expect to see on it

A

USS

Would see a haematoma

22
Q

What are the risk factors for placenta abruption

A

Old maternal age

Multiple pregnancies

Smoking

Pre-eclampsia

Past history

Cocaine

23
Q

Why is cocaine a risk factor for placenta abruption

A

As it is a vaso-constrictor

24
Q

What is placenta abruption associated with

A

Placenta previa

Pre-term labour

Chorioamnioinitis (inflammation of the chorion)

25
Q

What are the treatments for placenta abruption

A

C-section

Tranexamic acid

Anti-D immunoglobulins

26
Q

If the mum suffering from placenta abruption is rhesus -ve, then what must you give them

A

Anti-D immunoglobulins

27
Q

Why is tranexamic acid used to treat placenta abruption

A

As it prevents blood clots from breaking up, so stops the bleeding

28
Q

What are some of the potential complications of placenta abrutpion

A

Fetal death

Couvailaire uterus (concealed)

Maternal shock (due to blood loss)

PPH

Maternal dissemnated intravascula cogaulation (DIC)

29
Q

How can a placental aburption lead to fetal death

A

As the blood loss can cause fetal hypoxia, which can lead to aphyxia

Fetal aphyxia causes the baby to suffocate, become unconciouss, and finally…death

30
Q

How can placental abruption lead to fetal metabolic acidosis

A

As the hypoxia due to the blood loss can produce lactic acid

Systems- Repro (14 decks)

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