Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obs and Gynae > Placental abruption > Flashcards

Placental abruption Flashcards

1
Q

What is placental abruption?

A

When part (or all) of the placenta separates before delivery of the foetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can happen when the placenta separates?

A

Considerable bleeding may occur behind it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can happen to the blood from a placental abruption?

A
  1. Further placental abruption and acute foetal distress may occur
  2. Blood can track down between the membranes and the myometrium to be revealed as APH
  3. May enter the liquor
  4. May enter the myometrium and visible haemorrhage is absent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a concealed abruption?

A

When the blood from the separation enters the myometrium and there is no PV bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Shock in placental praevia and abruption?

A 
Abruption = Inconsistent with external loss
Praevia = Consistent with external loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pain in placental praevia and abruption?

A 
Abruption = Common, often severe, Constant with exacerbations
Praevia = No. Contractions occassionally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bleeding in placental praevia and abruption?

A 
Abruption = May be absent. Often dark
Praevia = Red and often profuse. Often smaller APHs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tenderness in placental praevia and abruption?

A 
Abruption = Usual, often severe. Uterus may be hard
Praevia = Rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Foetal lie in placental praevia and abruption?

A 
Abruption = Lie normal, often engaged. May be dead or distressed
Praevia = Lie often abnormal / head high. Heart rate usually normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

USS in placental praevia and abruption?

A 
Abruption = often normal, placenta not low
Praevia = Placenta low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of placental abruption?

A
  1. Foetal death (30%)

2. Haemorrhage often necessitates blood transfusion; this, DIC and renal failure rarely lead to maternal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is the uterus described in placental abruption?

A

As ‘woody’ hard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RFx for placental abruption?

A
  1. IUGR
  2. Pre-eclampsia
  3. Autoimmune disease
  4. Maternal smoking
  5. Cocaine usage
  6. Hx of placental abruption
  7. High maternal parity
  8. Occasionally trauma or sudden reduction in uterine volume (e.g. rupture of membranes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hx in placental abruption?

A

Painful bleeding
Pain = blood behind placenta and in myometrium, usually constant with exacerbations
Blood = often dark
Amount of blood doesn’t reflect severity of abruption as not all blood will leave via vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examination in placental abruption?

A
  1. Tachycardia = profound blood loss (may be out of proportion to vaginal loss due to concealed loss)
  2. Hypotension = massive loss
  3. Uterus tender and often contracting; labour often ensues
  4. Severe cases = woody hard
  5. Foetus hard to feel
  6. Foetal heart tones are often abnormal or even absent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is diagnosis of placental abruption made?

A

Usually on clinical grounds

17
Q

How is foetal wellbeing established in placental abruption?

A
  1. CTG
  2. Tocography to monitor uterine activity
  3. USS to estimate foetal weight and exclude placenta praevia
18
Q

How is maternal wellbeing established in placental abruption?

A
  1. FBC
  2. Coagulation screen
  3. Blood cross-match
  4. Catheterisation with hourly urine output
19
Q

Mx of placental abruption?

A
  1. Admit
  2. Resuscitation if required
  3. IV fluid given
  4. Steroids given if gestation <34 weeks
  5. Opiate analgesia
  6. Anti-D to Rhesus negative women
20
Q

What does delivery depend on?

A

Foetal state and gestation

21
Q

What is done if there is foetal distress?

A

Urgent delivery by c-section

22
Q

What is done if there is no foetal distress, but gestation is >37 weeks?

A

Induction of labour with amniotomy. Foetal heart closely monitored. Maternal condition closely observed and c-section if foetal distress ensues

23
Q

What is done if the foetus is dead?

A

Coagulopathy is also likely. Blood products are given and labour is induced

24
Q

When is conservative Mx done?

A

No foetal distress, preterm pregnancy and minor degree of abruption

25
Q

Conservative Mx?

A
  1. Steroids given if <34 weeks
  2. Monitor pt closely on antenatal ward
  3. If all Sx settle, can be discharged
  4. However, pregnancy is now ‘high risk’; USS for foetal growth performed

Obs and Gynae (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions