Antepartum haemorrhage Flashcards Preview

Obstetrics > Antepartum haemorrhage > Flashcards

Flashcards in Antepartum haemorrhage Deck (30):
1

definition

genital tract bleeding from 24 weeks gestation

2

causes APH

placental abruption, placenta praevia, vasa praevia, uterine rupture, cervical polyps, erosions, carcinoma, cervicitis, vaginitis

3

signs placenta praevia

shock in proportion to visible loss, NO PAIN, uterus non tender, lie and presentation may be abnormal, fetal heart usually normal, coag probs rare, small bleeds before the large

4

signs placenta rupture

shock out of keeping with visible loss, pain constant, tender tense uterus, normal lie and presentation, fetal heart absent or distressed, coag problems

5

what should you be worried about in placental rupture

pre eclampsia, DIC, anuria

6

what happens to risk of PPH in both praevia and rupture

increased risk. lower segment may not contract well after placenta praevia

7

what is placenta praevia

placenta lies in lower uterine segment. 0.5%

8

associations placenta praevia

c section, sharp curette TOP, multiparity, multipole pregnancy, mother >40, assisted conception, D&C, fibroids, endometriosis

9

management of major and minor placenta praevia

major- C section. minor- normal delivery

10

what is a minor placenta praevia

doesn't cross the internal os

11

presentation APH

APH or failure of head to engage

12

management placenta praevia

no vaginal exam. assess blood loss and cross match. severe bleeding- urgent delivery if less severe and

13

what could happen to the baby in episodes of heavy bleeding

hypoxia

14

complications of placenta praevia

haemorrhage, placenta accreta or percreta

15

when would an elective c section be planned in placenta praevia

38 weeks

16

what is placental abruption

placenta becomes detached from uterus

17

associations abruption

IUGR, smoking, infection, vertex presentation, pre eclampsia, multiple pregnancy, polyhydramnios, incr age, thrombophilia, trauma, assisted reproduction

18

complications abruption

placental insufficiency, uterine compression leading to tender uterus, DIC, backache

19

what may concealed abruption lead to

maternal shock

20

investigations in abruption

FBC, USS, CTG

21

management abruption- when to admit patient

pain and uterine tenderness. IV fluids and steroids if

22

what should delivery be in abruption

urgent C section if fetal distress. induction of labour if >37 weeks and no distress

23

management minor pre term abruption

no distress. give steroids, monitor serial USS

24

what colour is the blood in praevia/abruption

praevia- fresh red, profuse. abruption- dark red, can be concealed and not bleed

25

what is placenta accreta

all or part of placenta abnormally attached to the myometrium

26

treatment placenta accreta

C Section hysterectomy. DIC common

27

what is released to cause DIC

thromboplastin

28

what is vasa praevia

fetal vessels lying within placental membranes which cross the internal os.

29

when is the vasa praevia at risk of tearing

when the membrane ruptures

30

when is vasa praevia more common

following IVF