Abnormal pregnancy II

Question 1

Placenta location over/close to cervical os

Answer 1

Placenta previa

Question 2

pt presentation for placenta previa

Answer 2

Painless vaginal bleeding in 3rd trimester

Question 3

Degrees of placenta previa

Answer 3

• Complete: os completely covered
• Partial: os partially covered
• Marginal: edge of placenta at margin of os
• Low lying placenta: lower uterine segment w/ edge any 2cm from os

Question 4

diagnostic test for placenta previa

Answer 4

*Transabd -> TVU/S

Question 5

How early can placenta previa be recognized

Answer 5

2nd trimester U/S

Question 6

Which types of placenta previa could potentially spontaneously resolve

Answer 6

Partial, marginal and low lying at 33-35 wks

Question 7

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

Answer 7

Bimanual exam

Question 8

Placenta previa mgt w/out active bleed

Answer 8

Hospitalize, corticosteroids if

Question 9

Placenta previa mgt w/ active bleed/spontaneous labor

Answer 9

Immediate C-section

Question 10

Placenta accreta

Answer 10

Growing into uterine wall

Question 11

Placenta increta

Answer 11

Invasion of myometrium

Question 12

Placenta percreta

Answer 12

Perforate uterus into bladder and rectum

Question 13

Abn. premature separation of membranes in

Answer 13

Placenta abruptio

Question 14

pt presentation of placenta abruptio

Answer 14

+/- painful hemorrhage w/ fetal distress

Question 15

Risk factors of placental abruption

Answer 15

preeclampsia/chronic HTN, cocaine/amphetamine use, abdominal trauma

Question 16

Types of abruption

Answer 16

Complete
Partial
marginal

Question 17

What coagulopathy do you watch for in placental abrution

Answer 17

DIC

Question 18

placenta abruptia mgt

Answer 18

• marginal: watch and tx hemodynamic instability

* Fetal distress: C-section + corticosteroids if

Question 19

Fetal blood vessels running unsupported through the membranes over cervix and under presenting fetal part

Answer 19

Vasa previa

Question 20

pathophys of vasa previa

Answer 20

• Velamentous insertion of cord

* cord insertion btn 2 lobes of accessory lobed placenta

Question 21

Pt presentation of vasa previa

Answer 21

Painless vaginal bleeding at ROM w/ fetal distress (∆ in fetal heart tracing)

Question 22

Diagnostics for vasa previa

Answer 22

U/S w/ color doppler
Apt test (if risk factors)

Question 23

Mgt of vasa previa

Answer 23

Hospitalization in 3rd trimester, corticosteroids, pelvic rest
C-section at 35wks

Question 24

Risk factors for vasa previa

Answer 24

Multiple gestation
Low lying placenta
bilobed/accessory lobed placenta
IVF pregnancy

Question 25

Spontaneous ROM before onset of labor

Answer 25

PROM

Question 26

How long after PROM should labor start

Answer 26

within 24hrs

Question 27

What could happen if labor doesnt start within 24hrs following PROM

Answer 27

Chrorioamonitis

Question 28

Risks due to PROM

Answer 28

Prolapse of cord (biggest risk) preterm labor intrauterine infection

Question 29

PROM before 37 wks

Answer 29

PPROM

Question 30

potential pathophys for PROM

Answer 30

STIs | BV