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Year Three - Reproductive System > Placental Abruption > Flashcards

Placental Abruption Flashcards

1
Q

What is placental abruption?

A

When the placenta separates from the wall of the uterus prematurely before the birth of the baby

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2
Q

When does placental abruption present?

A

Third trimester

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3
Q

What is the main complication of placental abruption?

A

Antepartum haemorrhage

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4
Q

What is antepartum haemorrhage?

A

Vaginal bleeding from week 24 of gestation until delivery

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5
Q

What are the two classifications of placental abruption?

A

Revealed

Concealed

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6
Q

What is a revealed placental abruption?

A

It occurs when the cervical os remains open, and any bleeding that occurs tracks down from the site of placental separation and drains through the cervix

This results in vaginal bleeding

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7
Q

What is a concealed placental abruption?

A

It occurs when the cervical os remains closed, and any bleeding that occurs remains within the uterine cavity

It typically forms a clot retroplacentally, with no vaginal bleeding present

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8
Q

What are the nine risk factors of placental abruption?

A

Increasing Maternal Age

Multiparity

Previous Placental Abruption

Pre-Eclampsia

Gestational Hypertension

Multiple Pregnancy

Polyhydramnios

Cocaine Misuse

Smoking

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9
Q

What pneumonic can be used to remember the risk factors of placental abruption?

A

ABRUPTION:

A = previous Abruption
B = high Blood pressure
R = Ruptured membranes
U = Uterine injury
P = Polyhydramnios
T = Twins
I = Infection in the uterus (chorioamnionitis)
O = Older age> 35
N = Narcotic use (cocaine, amphetamines, smoking)

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10
Q

What are the four clinical features of placental abruption?

A

Constant, Severe Abdominal Pain

Tender, Tense ‘Woody’ Uterus

Painful Vaginal Bleeding

Shock

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11
Q

What are the two clinical features of shock?

A

Tachycardia

Hypotension

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12
Q

What investigation is used to diagnose placental abruption?

A

US scan

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13
Q

What are the three features of placental abruption on an US scan?

A

Normal Fetal Lie & Presentation

Absent or Distressed Fetal Heartbeat

Retroplacental Haematoma

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14
Q

How is an US scan used to diagnose placental abruption?

A

An ultrasound scan can be useful in excluding placental praevia, however is not very good at diagnosing or assessing abruption

The diagnosis is usually based on clinical presentation

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15
Q

What is the management option for placental abruption in cases where the fetus is alive, with gestation before 36 weeks - with no features of fetal distress?

A

Conservative management, with admission for observation and the administration of corticosteroids

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16
Q

What is the management option for placental aburption in cases where the fetus is alive, with gestation before 36 weeks - with features of fetal distress?

A

Immediate C-Section

17
Q

What is the management option for placental aburption in cases where the fetus is alive, with gestation after 36 weeks - with no features of fetal distress?

A

Vaginal Delivery

18
Q

What is the management option for placental aburption in cases where the fetus is alive, with gestation after 36 weeks - with features of fetal distress?

A

Immediate C-Section

19
Q

What is the management option for placental aburption in cases where the fetus is dead?

A

Vaginal Delivery Induction

20
Q

When do we prescribe anti-D to placental abruption patients?

A

Within 72 Hours - if the woman is rhesus D negative

21
Q

What investigation is used to determine the dose of anti-D prescribed to placental abruption patients?

A

Keilhauer test

22
Q

What is a Keilhauer test?

A

It is a test is used to quantify how much fetal blood is mixed with the maternal blood

23
Q

What are the four maternal complications of placental abruption?

A

Shock

Disseminated Intravascular Coagulation

Renal Failure

Post-Partum Haemorrhage

24
Q

What are the two fetal complications of placental abruption?

A

Intrauterine Growth Restriction
Hypoxia

Year Three - Reproductive System (52 decks)

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