Flashcards in Alterations In Intrapartal Deck (51)
Who gets RhoGAM ? When do they get it?
Rh - mom, 28 week and within 72 hours of delivery
Uterus doesn't contract keeps becoming boggy
What is dystocia
Things that could cause difficult labor
What are operative obstetrics techniques
Help facilitate fetus to be brought to the outside
What part of uterus is where there is very little contacting done
Where is placenta normally?
Upper front part if uterus
Placenta previa is improperly implanted placenta in the _________ with ____________
In lower uterine segment with painless bright red bleeding
Risk factors for placenta previa
Maternal age and number of C/S
Scaring in upper uterine segment
Concerns with placenta previa
Bleeding, hemorrhage.. "Afterbirth comes first"
What is a medication to stop contractions and calm uterus? When would you use it?
Tocolytics, placenta previa
Why should there be no nipple stimulation or vaginal exam with placenta previa?
Release oxytocin which stimulate contractions. We do nothing to stimulate contractions. But if vaginal exam had to be done you have to have a double set up.
Premature separation or NORMALLY implanted placenta from uterine wall
What kind of bleeding would you see with a marginal Abruptio placenta
Bright red bleeding
What's important about central Abruptio placenta
May not know she has it until she delivers the baby. There will be fast bleeding which will cause the uterus to swell up and there will be a big clot behind placenta which can be painful for mom
What is important about fundal height with the complete Abruptio placenta
Fundal height will be much bigger than expected
What is a concern with severe central Abruptio placentae?
May observe Couvelaire uterus (blue uterus, abnormal fundal height, mother c/o of lots of pain) and risk of DIC ( disseminated intravascular clotting)
What is DIC
disseminated intravascular clotting- excessive activation of clotting factors and then they run out and bleeding occurs. insult that occurs in relation to something else it is not a disease by itself.
If there is vaginal bleeding should you do a vaginal or rectal exam?
Not without a double set up!!
What color bleeding with Abruptio placenta? Why?
Dark red bleeding because it is behind placenta
Symptoms of Abruptio placenta
Dark red bleeding, shock, severe abdominal pain
What is somebody with Abruptio placemat at a increased risk for
Hemorrhage, fetal distress, preterm labor/delivery depending on placenta problem
What is Cryoprecipitate
Used with Abruptio placenta
Is the clot usually visible on the ultrasound with Abruptio placenta?
Less than 50% of cases
Where should cord normally attach
More towards the center
What are the three different ways of placental adherence?
*Accreta - (most common) superficially into myometrium
*Increta- myometrium invaded
*Percreta- myometrium penetrated
What is the most common type of placental adherence where the chronic villi attach directly to myometrium of uterus
Type of placental adherence where myometrium is invaded, attached deep into myometrium
Type of placental adherence where myometrium is penetrated, attached through the myometrium
Concerns with placental problems & umbilical cord variations
Hemorrhage failure of placenta to separate; abnormal separation of placenta