Womens Health ILA Flashcards
1
Q
What are some causes of antepartum bleeding?
A
- Placental abrasion
- Placenta praevia bleeding
- Trauma
- Vasa praevia
- Cervical cancer
- Cervical Ectropion
- Abnormally adherent placenta
2
Q
What to ask in obs history taking
A
- Obs history
- Pain history
- Bleeding history
- Previous scans
- Gestational age
- Systemic history
- Foetal movements
- N&V
- DVT symptoms
3
Q
Risk factors for placental abruption
A
- Antilipid syndrome
- Previous placental abruption
- Pre-eclampsia
- Bleeding early in pregnancy
- Trauma (consider domestic violence)
- Multiple pregnancy
- Fetal growth restriction
- Multigravida
- Increased maternal age
- Smoking
- Cocaine or amphetamine use
4
Q
Initial assessment and management of antepartum bleeding
A
- ABCDE assessment
- Abdominal examination
- USS - placenta placement, how many babies
- Speculum - bleeding, cervix dilated?
- Put on CTG
- Take bloods - cross match, FBC, U&E, coagulation
- Give fluids
5
Q
Define major and minor postpartum haemorrhage
A
Major postpartum haemorrhage = >1000ml
Minor pph = 500-1000 ml
6
Q
Risk factors for post partum haemorrhage
A
- Multiple pregnancy
- Instrumental delivery
- Large baby
- Long labour
- C section
- History of fibroids
- Delay in delivery of placenta
- Induction of labour
- Obesity
- Anaemia
- Pyrexia in labour
7
Q
Four Ts of pph
A
- Trauma
- Thrombin - bleeding tendency.
- Tone - 70% atonic uterus
- Tissue - retained in uterus
8
Q
Management options for PPH
A
- Uterine balloon - conservative
- B linch suture (brace stitches around uterus to aid contraction)
- Ligate internal iliac/ uterine artery
- Hysterectomy
9
Q
A
