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ObGyn > Antepartum Hemorrhage > Flashcards

Antepartum Hemorrhage Flashcards

1
Q

Describe 4 classes of APH

A

PV spotting
Minor <50ml
Major : 50-1000ml w/o shock
Massive >1000ml with shock

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2
Q

Risk factors of placenta previa x5

A

Previous placenta previa
Previous C section
Multiple gestation
Multiparity
Advanced maternal age

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3
Q

Factors likely to cause deficient endometrium x4

A

Uterine scar
Endometritis
Submucous fluid
Manual removal of placenta

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4
Q

State 4 classes of placenta previa

A

Low lying, marginal, partial, complete

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5
Q

True or false : Placenta previa bleeding is usually painful

A

False

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6
Q

True or false: P. previa is usually associated with breech presentation and non longitudinal lie

A

True

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7
Q

Factors influencing management of p.previa x3

A

GA
Severity of APH
Type of placental previa

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8
Q

Fetal complications of p.previa x3

A

Prematurity
Still birth
Fetal anoxia- complete loss of blood supply

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9
Q

Maternal complications of APH caused by p.previa x5

A

Shock, sepsis
Anemia
Death
Placental abruption
Postpartum endometritis

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10
Q

True or false: You can do a vaginal exam in a patient with p.previa

A

False

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11
Q

Risk factors of placenta abruption x5

A

Trauma
Previous abruption
Hypertensive disorders
Advanced maternal ages
Multiparity, multiple gestation

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12
Q

Describe effect of smoking on placental health x5

A

Smoking> vasoconstriction> ischemia> necrosis and hemorrhage> placental separation

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13
Q

Define placenta abruption

A

Premature separation of a previously implanted placenta from 28wk+ of gestation

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14
Q

3 types of p.abruption

A

With revealed hemorrhage
With concealed hemorrhage
Mixed p.abruption

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15
Q

Causes of APH x5

A

Placenta previa
Placenta abruption
Vasa previa
Varicosities
Uterine rupture

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16
Q

Complications of placenta previa x5

A

PPH
Placenta accreta
Fetal distress
Preterm labour
Amniotic fluid embolism

17
Q

Goal of BP and urine output in resuscitation

A

SBP >100
Urine >30ml/hr

18
Q

Management of APH in Rh neg mother > 20wks

A

300 microgram Rh IgG 6 weekly

19
Q

Maternal complications of placenta abruption x5

A

PPH
DIC
Shock
Renal failure
Death

20
Q

Fetal complications of placenta abruption x3

A

Growth restriction
IUFD
Prematurity

21
Q

Define vasa praevia

A

Unprotected fetal vessels run between chorion and amnion passing through the cervical os

22
Q

2 types of vasa previa

A

Velamentous cord insertion
Bilobed placentas

23
Q

Painless pv bleeding after ROM

A

Vasa praevia

24
Q

Pathophysiology of placenta abruption

A

Rupture of decidual spiral artery and hemorrhage into decidual basalis
Hematoma splits decidual leaving thin layer adherent
Hematoma grows to lift and compress adjacent placenta > detachment

ObGyn (34 decks)

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