Uw uterus: rupture, vasa, abruptio

Question 1

UTERINE RUPTURE. in what patients?

Answer 1

Occurs in patients with prior history of uterine surgery

Question 2

UTERINE RUPTURE. CP?

Answer 2

2. Pain presentation:
   a. Focal and intense, which is relieved by rupture
   b. Diffuse pain after the rupture

Question 3

UTERINE RUPTURE. Signs of imminent rupture?

Answer 3

a. Hyperventilation
b. Agitation
c. Tachycardia
d. Bleeding (can be vaginal or intra-abdominal)

Question 4

UTERINE RUPTURE. pathognomonic for rupture?

Answer 4

Loss of fetal station is pathognomonic for rupture

Question 5

UTERINE RUPTURE. Dx? 3 cia kas jauciama/matoma su fetal

Answer 5

6. Diagnosis
   a. Fetal limbs palpable on abdominal exam
   b. Fetal heart tracings are abnormal (eg, fetal tachycardia, recurrent decelerations)
   c. Disordered contractions occur because ruptured myometrial fibers cannot contract in unison, leading to progressively decreasing contraction amplitude (ie, staircase sign on
   tocodynamometry)

Question 6

UTERINE RUPTURE. table. risk factors?

Answer 6

Prior uterine surgery (eg cesarian delivery, myomectomy)

Induction of labor/prolonged labor

Congenital uterine anomalies

Fetal macrosomia

Question 7

UTERINE RUPTURE. table. CP?

Answer 7

Vaginal bleeding
Intraabdominal bleeding (hypotension, tachycardia)
Fetal heart decelerations
Loss of fetal station
Palpable fetal parts on abdominal examnination
loss on intrauterine pressure

Question 8

UTERINE RUPTURE. table. Tx?

Answer 8

Laparotomy for delivery and uterine repair

Question 9

yra uterine rupture deceleracijos visokios.

Answer 9

.

Question 10

vasa previa. table. definition?

Answer 10

fetal vessels on overlying the cervix

Question 11

vasa previa. table. risk factors, 4?

Answer 11

placenta previa
multiple gestations
in vitro fertilization
succenturiate placental lobe

Question 12

vasa previa. table. CP?

Answer 12

painless vaginal bleeding with ROM or contractions
FHR abnormalities (bradycardia, sinusoidal pattern)
Fetal exsanguination and demise

Question 13

vasa previa. table. mx?

Answer 13

emergency cesarean delivery

Question 14

vasa previa. notes. when Dx?

Answer 14

vasa previa is diagnosed on fetal anatomy ultrasound at 18-20 weeks

Question 15

vasa previa. notes. mx?

Answer 15

it is managed with C-section at 34-35 weeks gestation (ie prior to spontaneous labor)

Question 16

Placental abruption. table. risk factors. 4

Answer 16

maternal hypertension or preeclampsia/eclampsia
abdominal trauma
prior placental abruption
cocaine/tobacco use

Question 17

Placental abruption. table. CP? 4

Answer 17

sudden-onset vaginal bleeding (80 proc.)
abdominal or back pan
high-frequency, low intensity contractions
hypertonic, tender uterus

Question 18

Placental abruption. table. Dx? 3

Answer 18

Primarily by clinical presentation
UG (not required for Dx) to rule out placenta previa. May show retroplacental hematoma

Question 19

Placental abruption. irgi deceleracijos.

Answer 19

.