Third Trimester Bleeding Flashcards

1
Q

If a patient presents with spotting or bleeding accompanied with contractions or cramping this could indicate

A

cervical dilation and labor

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2
Q

two concerning reasons for bleeding in the 2nd and 3rd trimester

A

placenta previa

placental abruption

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3
Q

complication of pregnancy which placenta lies over the cervix instead of along one of the uterine walls → diagnosed during routine ultrasound but can present with vaginal bleeding

A

placenta previa

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4
Q

this occurs when placenta begins to separate from the wall of the uterus prematurely (prior to delivery) → may cause painful contractions

A

placental abruption

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5
Q

the 3 main vessels of the placenta and what cushions them?

A

2 arteries and 1 vein

Wharton’s Jelly

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6
Q

what does the placenta provide the fetus?

A

nutrients, water, oxygen

way to excrete waste

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7
Q

How does placental weight compare to fetal weight?

A

approximately one seventh the fetal weight

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8
Q

what is the mean amniotic fluid at term?

A

500 ml

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9
Q

The placenta has immunological properties and produces what?

A

steroid hormones, estrogen, progesterone, growth factors, pituitary like hormones and proteins

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10
Q

mechanisms that substances transverse the placental membrane

A

passive diffusion
facilitated diffusion
active transport
endocytosis and exocytosis

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11
Q

what kind of substances readily diffuse through the trophoblastic membrane?

A

highly lipid soluble

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12
Q

How are respiratory gases (oxygen and carbon dioxide) transported between maternal and fetal circulation?

A

partial pressure gradient between the 2

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13
Q

glucose transfer from mother to fetus rates will ___ as maternal glucose concentration increases

A

decreases

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14
Q

painful bleeding + rigid abdomen

A

abruptio placenta

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15
Q

plainless bleeding

A

placenta previa

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16
Q

Ddx for painless bleeding in 3rd trimester

A

placenta previa

vasa previa

17
Q

Ddx for painful bleeding in the 3rd trimester

A

placenta abruption
uterine rupture
labor

18
Q

causes of abruptio placenta

A

hypertension
cocaine use
trauma
multiparity

19
Q

Method used to diagnose abruptio placenta

A

pelvic ultrasound

20
Q

treatment for abruptio placenta

A

hospitalize for hemodynamic management → C-section

21
Q

complications of abruptio placenta

A

dessimated intravascular coagulation

22
Q

infarcts in the maternal surface of the placenta that occur when there is separation of the placenta from the uterus

A

placental infarcts

23
Q

premature aging of the placenta due to maternal complications, poor nutrition, smoking may cause what on the placenta?

A

calcifications

24
Q

implantation on or close to the cervical os either total or partial or marginal

A

placenta previa

25
Q

How do you differentiate partial or marginal placenta previa?

A

dilation of cervix and method of diagnosis

26
Q

leading cause of 3rd trimester bleeding

A

placenta previa

27
Q

encroachment of placenta on margins of the cervical os

A

marginal placenta previa

28
Q

risk factors for placenta previa

A

advanced maternal age, multiparity, smoker and cocaine use in pregnancy, male sex, hx of C-section, prior abortions and uterine surgery, hx of placenta previa

29
Q

90% of placenta previa found in 2nd trimster resolve by the 3rd → changes in architecture secondary to differential growth of lower uterine segment during 2nd and 3rd trimester may account for

A

placental migration

30
Q

this occurs when chorionic villi attach to the myometrium rather than limited to the decidua basalis

A

acreta

31
Q

this occurs when the chorionic villi invade the myometrium

A

increta

32
Q

this occurs when chorionic villi invade through the myometrium to the level of the serosa or beyond it

A

precreta

33
Q

rupture of fetal vessel that transverse the membranes in the lower uterine segment/cervical os → painless vaginal bleeding

A

vasa previa

34
Q

treatment for vasa previa

A

immediate C section

35
Q

umbilical cord inserts into the fetal memrabens (choriamniotic membranes) then travels within the membrane to the placenta (between the amnion and chorion) → exposed vessels lack Wharton’s jelly and are vulnurable to rupture

A

velementous insertion

36
Q

not every pregnancy with velamentous cord insertion results in vasa previa, only those where …

A

blood vessels are near the cervix