Placental abruption/ Previa/ premie membrane rupture Flashcards
What is placental abruption
premature separation of a placenta after 20 weeks
What can cause placental abruption
Moms vessels rupture= blood accumulates= separation of decidua from placental attachment
Detached placenta unable to exchange gas/nutrients= fetal compromise
How does placental abruption present
Abrupt, PAINFUL vaginal bleeding
abdominal/back pain
contractions
How do you diagnose placental abruption
Clinically
+/- US shows retroplacental hematoma
How do you manage placental abruption
Closely monitor hemodynamica
Continuous fetal monitoring
“expectant management” only if mom is stable and baby is in NAD
If mom or fetus are unstable: Emergency C section
What is placenta previa
abnormal location of placenta over, or close to, internal cervical os
unknown cause!
RF for placenta previa include
Hx of C section
multiple gestation
Hx of previa
AMA
How does placenta previa present
painLESS vaginal bleeding after 20 weeks
What are the types of placenta previa
Low lying: near internal os
Partial: internal os partially covered
Complete: internal os is completely covered
How can you tell the difference between placenta previa and placental abruption
Previa is painless vaginal bleeding
Abruption is painful vaginal bleeding
How do you diagnose placenta previa
US!
NEVER perform a cervical exam; can cause hemorrhage!
How do you manage placenta previa
ASx: avoid intercourse, decrease physical activity. May resolve as pregnancy continues!
Sx: admit to hospital for close monitoring. C-section delivery
What is premature rupture of membranes
When membranes rupture BEFORE uterine contractions begin; essentially your water breaking (gush of clear/pale yellow fluid form vagina)
MCC of pre-term delivery
What si Pre-PROM
rupture of membranes before 37 weeks, WITHOUT uterine contractions
RF for PROM include
**Genital tract infection (BV)
Smoking
Hx of pre-term delivery
