Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproduction SOH > Problems in late pregnancy > Flashcards

Problems in late pregnancy Flashcards

1
Q

Bleeding in LATE pregnancy occurs any time after __ weeks gestation?

A

24

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

Ante partum haemorrhage (APH) - definition

A

Bleeding from the genital tract occurring from 24+0 weeks gestation and prior to the birth of the baby

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

Name 5 potential causes of APH

A 
Placenta praevia
Placental abruption
Placenta accreata
Uterine rupture
Vasa praevia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Spotting

A

Staining, streaking or blood spotting noted on underwear/when wiping

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

Minor haemorrhage - APH

A

Blood loss less than 50ml which has now settled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major haemorrhage - APH

A

Blood loss of 50-1000ml

No signs of clinical shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Massive haemorrhage - APH

A

Blood loss greater than 1000ml and/or signs of clinical shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is heavy show?

A

Mixture of blood and mucous which comes from a woman during labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Placental abruption - definition

A

Premature separation (either partially or totally) of a normally implanted placenta before the baby is born

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Placental abruption - pathogenesis

A

Vasospasm followed by arteriole rupture.
The blood escapes into the amniotic sac or further under the placenta and into the myometrium.
This causes continuous contraction and interrupts placental circulation, causing hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Placental abruption - clinical features

A

Continuous, severe, abdo pain
Bleeding
Pre-term labour (with heavy show)
Maternal collapse

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

Placental abruption - signs

A

Uterus

  • Uterine tenderness
  • Woody hard uterus

Foetal parts are difficult to identify
- as the sac is engorged with blood

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

Placental abruption - investigations

A

Assess foetal heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you use to assess foetal heart?

A

CTG

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

Investigations are needed to confirm the diagnosis of placental abruption. True or false?

A

False

- clinical diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Placental abruption - risk factors

A 
Pre-eclampsia 
Hypertension
Trauma - RTA, domestic abuse
Smoking 
Poly-hydramnios 
Multiple pregnancy 
Abnormal placenta 
Previous abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Placental abruption - management

A

Resuscitate mother

Rapidly assess and deliver baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do you do if no foetal heart is found on CTG?

A

Urgent US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Placental abruption - how do you delivery baby?

A

If baby is alive and seems well –> induction of labour

If baby is alive and seems poorly –> urgent C-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If a baby has died, you should deliver them by C-section. True or false?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Placental abruption - maternal complications

A

Hypovolaemic shock
Anaemia
PPH
Renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Placental abruption - foetal complications

A

Intra uterine death
Hypoxia
Prematiurity
SGA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Placenta praevia - definition

A

When the placenta is partially or totally implanted in the LOWER uterine segment (low lying placenta which covers all/part of the entrance aka internal cervical os)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Placenta praevia - what is the lower segment of the uterus?

A

The part of the uterus below the utero-vesical peritoneal pouch superiorly and the internal os inferiorly

25
Lower segment of the uterus contracts during labour. True or false ?
False | - passively dilates
26
Major praevia - definition
If the placenta lies over the internal cervical os
27
Minor/partial praevia - definition
If the leading edge of the placenta is in the lower uterine segment but not covering the internal cervical os
28
Placenta praevia - clinical features
Painless bleeding | - this is usually unprovoked but sex can trigger it
29
Placenta praevia - signs
Uterus is soft, non tender | Mal-presentations (breech, transverse, oblique)
30
If you suspect someone has placenta praevia, you should do a vaginal exam. True or false?
False | - do NOT do a vaginal exam on these patients
31
If an US scan around 20 weeks shows that the placenta extends over the cervix, what should be done?
Re-scan patients at 32 weeks
32
Placenta praevia - investigations
Transvaginal US scan | MRI (to exclude placenta accreta)
33
Investigations must be done to make a final diagnosis of Placenta praevia. True or false?
True | - requires a transvaginal US
34
Placenta praevia - risk factors
``` Previous caesarean section Smoking Assisted conception Previous placenta praevia Asian Previous TOP Advanced maternal age ```
35
Placenta praevia - management of foetal well being
Monitor foetal heart (CTG) Steroids (24+34+36 weeks) Magnesium sulphate (24-32 weeks)
36
Placenta praevia - delivery plan if placenta is >2cm from cervical os
Aim for vaginal delivery
37
Placenta praevia - delivery plan if placenta is <2cm from cervical os
Aim for caesarian section
38
Placenta Accreata - definition
Placenta is normally adherent to uterine wall
39
Placenta Accreata - clinical features
Severe bleeding
40
Placenta Accreata - risk factors
Previous caesarean sections | Placenta praevia
41
Placenta Accreata - management
Prophylactic internal iliac artery balloon
42
Uterine rupture - clinical features
Severe abdominal pain Maternal collapse PV bleeding Shoulder tip pain (due to blood spreading in the peritoneal cavity and irritating the diaphragm)
43
Uterine rupture - signs
``` Loss of uterine contractions Acute abdomen Presenting part of the placenta rises Peritonism Foetal distress ```
44
Uterine rupture - risk factors
Previous caesarean section Previous uterine surgery Multiparity Use of prostaglandins
45
Uterine rupture - management
Surgical management
46
Vas praevia - definition
Unprotected foetal vessels traverse the foetal membranes over the internal cervical os
47
Vas praevia - management
Steroids from 32 weeks | Delivery baby
48
PPH - definition
Post Partum Haemorrhage | Blood loss equal to or exceeding 500ml after the birth of the baby
49
PPH - classification
Minor | Major
50
Minor PPH - definition
500ml-1000ml blood loss | No clinical shock
51
Major PPH - definition
Over 1000ml blood loss or | Signs of CV collapse
52
PPH - types
Primary | Secondary
53
Primary PPH - definition
Occurs within 24 hours of delivery
54
Secondary PPH - definition
Occurs over 24 hours -> 6 weeks post delivery
55
PPH causes
``` 4 T's Tone Trauma - vaginal tears etc Tissue - is there any membrane left inside? Thrombin - is there a coagulopathy? ```
56
PPH - management for stopping the bleeding
``` Uterine massage 5 units IV syntocinon stat 40 units Foley's catheter Ergometrine IV Misoprostol Tranexamic acid ```
57
Avoid giving ergometrine to which patients ?
Cardiac disease | Hypertension
58
PPH - management of minor PPH
IV access | IV warmed crystalloid infusion
59
Active management of the third stage of labour
Syntometrine - combo of oxytocin and ergometrine Syntocinon

Reproduction SOH (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions