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Phase3 3a > Womens Health > Flashcards

Womens Health Flashcards

1
Q

What is an antepartum haemorrhage

A

•Bleeding from anywhere within the genital tract after the 24th week of pregnancy

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2
Q

Causes of Antepartum haemorrhage (4)

A

-low lying placenta/ placenta praevia
-vasa praevia
-minor/major abruption
-infection

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3
Q

What is low lying placenta

A

Any part of the placenta that has implanted into the lower segment of the uterus

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4
Q

What classes as a major and minor low lying placenta

A

Major - covering the Os
Minor - in lower segment not covering os

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5
Q

How to diagnose low lying placenta

A

20 week Ultrasound scan
Repeated at 32 weeks + 36 weeks

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6
Q

Mx of low lying placenta

A

•Advise to present if pain / bleeding

•Advise to avoid sexual intercourse

•If recurrent bleeds may require admission until delivery and ensuring has cross-match in date

•Remember to give anti-D if Rh negative

•Elective Caesarean section around 37/40

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7
Q

Signs and symtoms of placenta praevia

A

-painless vaginal bleeding
-light contractions

-lie and presentation of baby maybe abnormal

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8
Q

What is placental abruption

A

the complete or partial detachment of the placenta before delivery.

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9
Q

Cause of placental abruption

A

Unknown
Maybe trauma or injury

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10
Q

Risk factors of placental abruption

A

-maternal aged 35+
-Multiparity (e.g twins)
-pre eclampsia
-smoking during pregnancy
-use of cocaine during pregnancy
-trauma
-Hx of HTN
-Hx of anti phospholipid syndrome

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11
Q

Clinical presentation of placental abruption (5)

A

-Abdominal pain (most common) – posterior

-placental abruptions may present with back pain

-Vaginal bleeding

-Uterine contractions

-Dizziness and/or loss of consciousness

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12
Q

Clinal findings upon examination for placental abruption

A

-woody, tense uterus

-fetal heart may be absent or distressed

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13
Q

Investigations for placental abruption

A

Diagnostic - ultrasound scan to locate the bleed

Other
-vital signs
-FBC
-Clotting profile
-kelihauer test - fetal haemoglobin transferred from fetus to mother

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14
Q

Mx of placental abruption

A

Foetus alive
-fetal distress - immediate C-section
-no fetal distress - observe closely

Foetus dead - induce signal delivery unless mother heamodynamically unstable - then do C-section

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15
Q

Complications of placental abruption in:
Mother
Foetus

A

Complications in mother:
-Major haemorrhage
-Shock: can result in Sheehan syndrome - pituitary gland necrosis
-Compression of uterine muscles prevents good contraction of muscles during labour
-disseminated intravascular coagulation (DIC)
-Post-partum haemorrhage

Complications for the fetus:
Placental insufficiency: results in hypoxia and intrauterine growth restriction (IUGR) due to lack of nutrients
-Premature birth
-Stillbirth

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16
Q

What is vasa praevia

A

Fetal blood vessels (the two umbilical arteries and single umbilical vein) are within the fetal membranes and run across the internal cervical os.

17
Q

Risk factors for vasa praevia (3)

A

IVF pregnancy
Multiple pregnancy
Low lying placenta

18
Q

Sx of vasa praevia

A

-Painless vaginal bleeding
-Rupture of membranes
-Fetal bradycardia

19
Q

Investigations for vasa praevia

A

Diagnostic - ultrasound scan

Others:
Vital signs
FBC
Clotting profile
Kleihauer test

20
Q

Mx of vasa Praevia (3)

A

-if found on US then elective casearean section at 34-36 weeks

-corticosteroids given to promote fetal lung maturity

If Antepartum haemorrhage then emergency caesarean

21
Q

What is pre eclampsia

A

New high blood pressure in pregnancy with end organ dysfunction usually with proteinuria

22
Q

Triad of pre eclampsia

A

Oedema
Proteinuria
Hypertension

23
Q

Whats the pathology of pre eclampsia

A

after 20 weeks gestation, when the spiral arteries of the placenta form abnormally (more tangled), leading to a high vascular resistance in these vessels and poor perfusion of placenta.

Leads to oxidative stress in the placenta
Release of inflammatory chemicals into systemic circulation and impaired endothelial function of blood vessels

24
Q

What is eclampsia

A

When seizures occur as a result of pre-eclampsia.

25
Q

What is gestational HTN

A

Hypertension occurring after 20 weeks gestation, without proteinuria.

26
Q

High Risk factors for pre eclampsia (5)

A

Pre existing HTN
HTN before in pregnancy
Existing autoimmune conditions e.g lupus
Diabetes
CKD

Phase3 3a (8 decks)

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