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OB > Hemorrhagic Disorders/Abortions > Flashcards

Hemorrhagic Disorders/Abortions Flashcards

1
Q

Threatened Abortion

A

Vaginal spotting early in gestation. No passage embryonic or fetal tissue
Abdominal cramping
Cervix is closed

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2
Q

Management of Threatened Abortion

A

Possible mild activity restriction w/ bedrest 24-48 hrs, sedation
Avoid stimulation of sexual intercourse and orgasm for 2 wks

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3
Q

Inevitable Abortion

A

Pregnancy loss that cannot be prevented
Bleeding may be moderate/heavy
Cervix is dilated w/ tissue in cervix

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4
Q

Management of Inevitable Abortion

A

D & C (dilation and curettage) performed, vacuum curettage or administration of prostaglandin analog to evacuate the uterus

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5
Q

Incomplete Abortion

A

Pass of some of the products of conception. Ultrasound reveals retained material in the uterus. Cervix is open

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6
Q

Management of Incomplete Abortion

A

Cervix is open but may require additional dilation before curettage

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7
Q

Curettage

A

Scraping of a cavity or lesion

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8
Q

Complete Abortion

A

All fetal tissue and products of conception passed in bleeding. US reveals an empty uterus

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9
Q

Management of Complete Abortion

A

No further intervention may be needed if uterine contractions adequate to prevent hemorrhage and there is no infection. No need for treatment but follow up care to discuss related issues.

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10
Q

Septic Abortion

A

Fever
abdominal pain and tenderness
Bleeding from scant to heavy usually malodorous
Cervix is usually dilated

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11
Q

Septic Abortion Management

A

Termination of pregnancy
Culture and sensitivity studies to initiate appropriate antibiotic therapy

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12
Q

Missed Abortion

A

Retained nonviable embryo or fetus for 6 wks or more
Fetus has died and the placenta atrophied but the products of conception retained
Cervix is closed

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13
Q

Missed Abortion Management

A

Blood clotting factors are monitored
DIC w/ hemorrhage develops in case of fetal death after wk 12

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14
Q

Habitual or recurrent abortion

A

3 or more consecutive losses before 20 weeks of gestation
Cervix open

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15
Q

Habitual or Recurrent Abortion management

A

Identification and treatment of the underlying cause
Prophylactic cerclage if related to cervical insufficiency

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16
Q

Cervical insufficiency or short cervis

A

Cervical Internal OS opening or prolapsed fetal membranes

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17
Q

Management Cervical insufficiency

A

Cerclage: closing of the cervix w/ a purse-string stitch

18
Q

Ectopic Pregnancy (Tubal pregnancy)

A

Abdominal pain
Spotting
+ pregnancy test
verified by US
Signs of shoulder pain (ruptured tube)
signs of shock

19
Q

Ectopic Pregnancy Management

A

Tubal ligation and Methotrexate (nausea)

20
Q

What should be avoid with Ectopic Pregnancy

A

folic acid, sun exposure, sexual intercourse

21
Q

Why would you avoid these factors during ectopic pregnancy

A

Because they would cause NV and gastric discomfort

22
Q

Hydatidiform Mole (Molar pregnancy
True or False pregnancy?

A

False pregnancy; its a gestational trophoblast disease

23
Q

Hydatidiform Mole diagnosis

A

Transvaginal US and serum hCG

24
Q

Management of Hydatidiform Mole

A

Dilation and Currettage

25
Q

What is a pt w/ hydatidiform mole at risk of ?

A

Cancer

26
Q

Placenta Previa

A

Placenta is implanted in lower uterine segment

27
Q

Diagnosis of Placenta Previa

A

Painless bright red bleeding after 20 wks
US

28
Q

What should you never do to a pt w/ placenta previa

A

Stick your finger into their vag

29
Q

Management of Placenta Previa

A

Observation and bedrest

30
Q

How long a pt w molar pregnancy can not be pregnant for

A

1 yr

31
Q

Abruptio Placentae

A

premature separation of the placenta

32
Q

Diagnosis of Abruptio Placentae

A

Painful abdominal pain with or without bleeding
Uterine tenderness
Confirmed after delivery

33
Q

What is the management of Abruptio Placentae

A

Immediate delivery

34
Q

Vasa Previa

A

vessels are implanted into the fetal membranes instead of the placenta
Vessels cross over the internal OS

35
Q

How would you able to see Vasa Previa

A

US

36
Q

Management of Vasa Previa

A

Delivery by C-section

37
Q

Stillbirth is gestational age of >/= to ____ wks

A

20 weeks

38
Q

HELLP

A

Hemolysis, Elevated Liver Function, Low, Platelet Count

39
Q

Clinical Manifestations of DIC

A

Signs of Thrombosis
Bleeding from 3 unrelated sites
Spontaneous Epistaxis
Oozing from venipuncture sites
Petechiae
Ecchymosis (bruising)
Large subcutaneous hematomas
Hypotension
Tachycardia

40
Q

Would platelet count be high or low for a pt w/ DIC

A

LOW

41
Q

Would fibrinogen count be high or low for a pt w/ DIC

A

LOW

42
Q

How to manage a pt w/ DIC

A

Treat the underlying cause
Continue to monitor labs
Supportive management

OB (12 decks)

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