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Obs and Gynae > Placental Problems > Flashcards

Placental Problems Flashcards

1
Q

What is placenta praevia?

A

placenta is partially or totally implanted in the lower uterine segment

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2
Q

How is placenta praevia classified?

A

USS

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3
Q

Describe major placenta praevia.

A

Placenta lies over internal cervical os

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4
Q

Describe minor/partial placenta praevia.

A

Leading edge of placenta in lower uterine segment but not covering os

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5
Q

What are some risk factors for placenta praevia?

A

strong:
uterine scarring (prior c section)
infertility treatments
previous placenta praevia

weak:
previous TOP or miscarriage
>40 years

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6
Q

How does placenta praevia usually present?

A

Painless bleeding >24 weeks

Minor to severe

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7
Q

What can trigger the bleeding in placenta praevia?

A

Sex (however its usually unprovoked)

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8
Q

How is placenta praevia diagnosed?

A

transvaginal USS

DONT PERFORM VAGINAL EXAM UNTIL EXCLUDED

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9
Q

How is placenta praevia treated?

A

assess fetal wellbeing, monitor HR
may need major haemorrhage protocol
C section
resus and stabilisation

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10
Q

What is placenta accreta?

A

Placenta is abnormally adherent to uterine wall

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11
Q

What are risk factors for placenta accreta?

A

multiple C sections

placenta praevia

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12
Q

How does placenta accreta present?

A

severe bleeding

PPH

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13
Q

What does placenta accreta usually required?

A

hysterectomy

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14
Q

What is placental abruption?

A

separation of a normally implanted placenta - partially or totally before birth of the foetus

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15
Q

What does the outcome depend on in placental abruption?

A

amount of blood loss and degree of separation

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16
Q

What are the main risk factors for placental abruption?

A 
hypertension
cocaine use 
pre eclampsia 
smoking
previous abruption 
oligohydramnios
17
Q

What are the signs and symptoms of placental abruption?

A

severe abdominal pain
vaginal bleeding
uterine contractions and tenderness
woody, hard uterus

18
Q

What is the CTG like in placental abruption?

A

loss of variability, decelerations

19
Q

What is the treatment of placental abruption

A

stabilisation of mother - blood and fluid replacement
monitoring of mother and foetus
delivery - c section

20
Q

What are the maternal complications of placental abruption?

A 
hypovolaemic shock 
DIC
anaemia 
PPH 
coagulopathy 
renal failure
infection 
thromboembolism
21
Q

What are the foetal complications of placental abruption?

A

IUD
hypoxia
prematurity
small for gestational age and fetal growth restriction

22
Q

What is vasa praevia?

A

Unprotected fetal vessels traverse fetal membranes over internal cervical os

23
Q

When are the vessels at risk of damage in vasa praevia?

A

rupture of membranes

24
Q

What is the main risk in vasa praevia?

A

fetal haemorrhage

25
Q

How is the baby delivered in vasa praevia?

A

c section

26
Q

How is vasa praevia diagnosed?

A

USS

Obs and Gynae (27 decks)

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