6: Bleeding in late pregnancy Flashcards Preview

Reproduction Week 4 2018/19 > 6: Bleeding in late pregnancy > Flashcards

Flashcards in 6: Bleeding in late pregnancy Deck (66)
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1

What is bleeding called after 24 weeks gestation?

Antepartum haemorrhage

2

Bleeding before 24 weeks is a sign of what?

Miscarriage

threatened, inevitable etc.

3

Which report accounts for maternal deaths and is published every year?

MMBRACE

4

At what gestational age does the placenta develop?

6 weeks

5

What is the function of the placenta?

Gas exchange

Nutrient and metabolite exchange

Hormone production

6

What is an ante-partum haemorrhage?

PV bleeding from 2nd trimester (24 weeks) until the end of labour

7

What are some placental causes of APH?

Placenta praevia

Placental abruption

Placenta accreta

8

Name four placental causes of ante-partum haemorrhage.

Placental abruption​

Placenta praevia

Placenta accreta

Vasa praevia

9

Name a uterine cause of ante-partum haemorrhage.

Uterine rupture

10

Name three cervical causes of ante-partum haemorrhage.

Cervical cancer

Cervical polyps

Infection

11

 What is spotting?

Minor staining of blood on underwear or pads

12

What volumes of blood are lost in a

a) minor

b) major

c) massive APH?

a) < 50ml

b) 50 - 1000ml

c) > 1000ml

13

What is placental abruption?

Separation of placenta from uterus BEFORE birth

14

What are the symptoms of placental abruption?

Continuous abdominal pain - not intermittent as in labour

Bleeding

Pre-term labour

15

What is the recurrence rate for placental abruption?

10%

16

What does the uterus feel like on abdominal examination of a woman with placental abruption?

"Woody hard"

17

If you check for a foetal heartbeat in a woman with placental abruption and there is one, how is it managed?

Resuscitate the mother

Caesarean section

18

If you check for a foetal heartbeat in a woman with placental abruption and there isn't one, how is it managed?

Resuscitate the mother

Spontaneous passage / manual removal of pregnancy? wasn't explained

19

How is placental abruption managed?

Resuscitate mother

Deliver baby

20

Which investigations can be used to determine foetal heart rate?

Pinard stethoscope

Doppler ultrasound

CTG

21

If a mother with placental abruption is pre-term, how is her baby delivered?

Either caesarean section

or artificial rupture of membranes and IOL

22

What rheu condition may cause placental abruption?

Anti-phospholipid syndrome

Treated with LMWH and low dose aspirin

23

What condition is caused by implantation of the placenta in the lower uterus?

Placenta praevia

24

What terms are used when the placenta lies

a) close to the internal os

b) over the internal os

of the cervix?

a) Low-lying placenta

b) Placenta praevia

25

What is the lower segment of the uterus?

Thinner, non-contractile part of the uterus which is close to the internal os

Where the placenta goes in low-lying placenta / praevia and where you cut in a caesarean section

26

What is a LSCS?

Lower segment Caesarean section

27

What percentage of ante-partum haemorrhages are caused by placenta praevia?

20%

28

What percentage of deliveries are carried out by Caesarean section?

25 - 30%

29

What type of delivery is a risk factor for placenta praevia?

Caesarean section

30

Which investigation picks up placenta praevia?

Ultrasound

which is part of the reason they're routinely done at 12 and 20 weeks