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Repro > Third Tri & PP Bleeding > Flashcards

Third Tri & PP Bleeding Flashcards

1
Q

Complete or total previa

A

Placenta completely covers the os

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2
Q

Partial previa

A

placenta partially covers the internal os

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3
Q

Marginal previa

A

Edge of placenta extends to margin of internal os

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4
Q

Low lying placenta

A

Placenta lies in lower uterine segment, but does not extend to cervical os
Won’t attach to endometrial lining that is scarred

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5
Q

Placenta abruptio

A

Premature separation of the normally implanted placenta from it’s attachment to uterus

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6
Q

Uterine rupture

A

Complete separation of uterine musculature through all it’s layers

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7
Q

Postpartum hemorrhage

A

Blood loss in excess of 500 mL for vaginal and 1000mL for c-section

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8
Q

Placenta accreta

A

Placenta directly attached to myometrial wall

Absence of decidua basalis

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9
Q

Placenta increta

A

Placenta invades myometrium

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10
Q

Placenta percreta

A

Placenta penetrates myometrium to serosa or beyond

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11
Q

Hemodynamic changes in preggers

A 
Maternal blood vol increases (40%)
Plasma vol increased
Erythrocyte vol increased 
2,3 DPG increased 
Maternal blood pressure decreased 
HR, SV, CO, increased
Systemic vascular resistance decreased
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12
Q

Top three most frequent causes of maternal death in US

A

Embolism
HTN Disease
Obstetrical hemorrhage

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13
Q

Common causes of antepartum bleeding

A

Placenta previa

Placenta abruptio

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14
Q

In antepartum hemorrhage, do not check the cervix unless what has been ruled out?

A

Placenta previa

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15
Q

Most accurate means of determining cause of antepartum bleeding

A

Ultrasound

Picks up all previas, misses 50% of abruptions

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16
Q

Preterm premature rupture of membranes (PPROM)

A

Water breaks before 37 weeks

17
Q

Premature rupture of membranes (PROM)

A

Water breaks but no contractions yet

18
Q

Dx of placenta previa

A

Classic presentation is painless, bright red bleeding

19
Q

What should you never forget if the mother is Rh neg?

A

RHOGAM

20
Q

Kleihauer Betke

A

Gives percentage of fetal blood to know how much rhogam to give

21
Q

Risk factors for placenta abruptio

A 
Maternal HTN
COcaine abuse, especially crack
Trauma
Smoking
Polyhydraminos and multiple gestation
Previous abruption
22
Q

What is the most common cause of DIC in preggers?

A

Placenta abruptio

23
Q

MOA of placenta abruptio

A

Hemorrhage into decidua basalis with formation of hematoma
Separation of decidua from basal plate perpetuates itself and causes further separation as well as compression and destruction of tissue

24
Q

Couvelaire Uterus

A

Blueish purple discoloration to uterus caused by blood dissecting into myometrium

25
Q

Dx of placenta abruptio

A

Hallmark is painful vaginal bleeding in association with uterine tenderness, hyperactivity, and increased tone
Blood is usually dark red
US not useful
Uterus is firm, like a contraction that’s not going away

26
Q

Management of placenta abruptio

A

Stabilize mother

27
Q

Uterine rupture

A

Complete separation of uterine musculature through all of it’s layers
Fetus usually extruded in abdomen

28
Q

Dx of uterine rupture

A

Sudden onset of intense abdominal pain and vaginal bleeding

29
Q

Management of uterine rupture

A

Immediate laparotomy

Usually TAH is performed (TOC)

30
Q

Postpartum hemorrhage

A

Uterus fails to contract around myometrial spiral arterioles and decidual veins at attachment site after placental separation

31
Q

1 cause of postpartum hemorrhage

A

Uterine atony - won’t contract down; floppy, soft, and can have massive bleeding

32
Q

Management of postpartum hemorrhage

A

IV Pitocin

33
Q

Second most common cause of postpartum hemorrhage

A

Genital tract trauma

34
Q

Retained placenta

A

Fragments/pieces of placenta that did not come out
Accreta, increta, and percretas
Dx - exploration
Tx - manual removal or D&C

35
Q

Uterine inversion

A

Turning inside out of uterus
Usually iatrogenic
Pt can go into profound vasovagal shock
IT’S IN YO FACE, BITCH

36
Q

Management of uterine inversion

A

Immediate IV vol. expansion
Halothane anesthesia or terbutaline to relax uterus
Replace with fist and give immediate pitocin
Possible surgical suspension

37
Q

Which coagulation disorder has an 80% mortality DIC?

A

Amniotic fluid embolism

Repro (14 decks)

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