Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obstetrics and Gynaecology > Antepartum hemorrhage > Flashcards

Antepartum hemorrhage Flashcards

(51 cards)

Start Studying
1
Q

Definition

A

Bleeding after 20 weeks, prior to labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Definition

A

Bleeding after 20 weeks, prior to labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Incidence

A

3-5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Etiology

A

Uterine: placenta previa, placental abruption, vasa praevia, circumvallate placenta
Lower genital tract: cervical extropion, polyp, carcinoma, cervicitis, vaginitis
Unknown in 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Association of preterm infants and APH

A

20% preterm infants result of APH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

History

A 
Amount of bleeding
Onset
Pain
Contractions
Mucoid discharge
Triggering event-> intercourse (ectropion etc)
Last pap smear
STD history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most important distinguishing feature between placental abruption and placenta praevia

A

Constant abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examination

A 
Maternal well being:
Pulse, BP, T
Pallor
Abdominal tender, distension, ridigity
Speculum for cervical abnormalities
Digital examination- only when placenta praevia excluded, when contractions, to assess progress of cervix

Fetal well being:
Abdominal palpation for lie/presentation/engagement
CTG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Investigations

A 
FBC
Group hold/screen, cross match
Rhesus-->?Anti-D
Urine
UEC
LFT
Coagulation profile
Kleihauer tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the Kleihauer test and what does it indicate

A

Blood film->shows fetal RBCs in maternal circulation indicating placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition of placenta praevia

A

Placenta encroaches on lower segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define the lower segment of uterus

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Etiology of placenta praevia

A 
Multiparity
Multiples
Previous cesaerean
Smoking
\+Age
Fetal anomalies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Grading of PP

A

1: At lower segment, not reaching os
2: Reaches os, does not cover
3: Covers os only when not dilated
4: Covers os even when dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Presentation of PP

A 
Diagnosed on US
Painless bleeding
Pain->10% also have placental abruption
Postcoital bleeding
Spotting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Placenta previa and bleeding

A 
ABCs
2 large IV cannula, IDC
Infusion NS
Bloods group/screen/xmatch, anti-Dif Rh negative
Avoid all vaginal examination
USS, gentle speculum
If anemia, no longer bleeding, 10.5
Continue until can do C section
Consent and book for C section
Be sure to always have group and hold up to date- risk of PPH
If
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Placenta previa and bleeding

A 
ABCs
2 large IV cannula
Infusion NS
Bloods group/screen/xmatch, anti-Dif Rh negative
Avoid all vaginal examination
USS, gentle speculum
If anemia, no longer bleeding, 10.5
Continue until can do C section
Be sure to always have group and hold up to date- risk of PPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When might you consider an MRI

A

If suspect placenta accreta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is there +risk of post partum hemorrhage in PP

A

Lower segment does not contract as well and therefore less compression of the placental vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recurrence rate of PP

A

4-8% in subsequent pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Incidence

22
Q

Etiology

Study These Flashcards
A

Uterine: placenta previa, placental abruption, vasa praevia, circumvallate placenta
Lower genital tract: cervical extropion, polyp, carcinoma, cervicitis, vaginitis
Unknown in 50%

23
Q

Complications of placental rupture–>maternal and fetal

Study These Flashcards
A 
Maternal:
Hypovolemia
AKI
ARD
PPH
DIC
Death
Sheehans

Fetal:
Mortality
Preterm
IUGR
Anemia
Congenital
24
Q

History

Study These Flashcards
A 
Amount of bleeding
Onset
Pain
Contractions
Mucoid discharge
Triggering event-> intercourse (ectropion etc)
Last pap smear
STD history
25
Most important distinguishing feature between placental abruption and placenta praevia
Constant abdominal pain
26
Examination
``` Maternal well being: Pulse, BP, T Pallor Abdominal tender, distension, ridigity Speculum for cervical abnormalities Digital examination- only when placenta praevia excluded, when contractions, to assess progress of cervix ``` Fetal well being: Abdominal palpation for lie/presentation/engagement CTG
27
Investigations
``` FBC Group hold/screen, cross match Rhesus-->?Anti-D Urine UEC LFT Coagulation profile Kleihauer tests ```
28
What is the Kleihauer test and what does it indicate
Blood film->shows fetal RBCs in maternal circulation indicating placental abruption
29
Risk of recurrence of placental abruption in next pregnancy
8%
30
Define the lower segment of uterus
31
Etiology of placenta praevia
``` Multiparity Multiples Previous cesaerean Smoking +Age Fetal anomalies ```
32
Grading of PP
1: At lower segment, not reaching os 2: Reaches os, does not cover 3: Covers os only when not dilated 4: Covers os even when dilated
33
Presentation of PP
``` Diagnosed on US Painless bleeding Pain->10% also have placental abruption Postcoital bleeding Spotting ```
34
Management of asymptomatic low lying placenta
Rescan at 34 weeks to determine location If still grade 1/2 at 34 weeks, scan fortnightly Unless bleeding, do not need to admit If high presenting part/abnormal lie at 37 weeks, suggests placenta previa Final scan at 36-37 weeks and acted upon C-section done electively- major 37-38 weeks (usually when
35
Placenta previa and bleeding
``` ABCs 2 large IV cannula Infusion NS Bloods group/screen/xmatch, anti-Dif Rh negative Avoid all vaginal examination USS, gentle speculum If anemia, no longer bleeding, 10.5 Continue until can do C section Be sure to always have group and hold up to date- risk of PPH ```
36
When might you consider an MRI
If suspect placenta accreta
37
Why is there +risk of post partum hemorrhage in PP
Lower segment does not contract as well and therefore less compression of the placental vessels
38
Recurrence rate of PP
4-8% in subsequent pregnancies
39
Placental abruption definition and incidence
Premature separation of normally situated placenta, blood detaches 2% of pregnancies
40
Etiology/associations placental abruption
``` HTN Trauma Multiparity +Serum AFP Polyhydramnios, multiples Cocaine Previous abruption +Age Cigarrette External cephalic version ```
41
Difference between concealed and revealed placental rupture
Concealed-->30%, blood remains behind placenta X escape cervix Revealed -->70% escapes through cervix
42
Complications of placental rupture-->maternal and fetal
``` Maternal: Hypovolemia AKI ARD PPH DIC Death ``` ``` Fetal: Mortality Preterm IUGR Anemia Congenital ```
43
Presentation of placental rupture
``` Pain Vaginal bleeding Labour Abdominal tenderness Fetal distress Hypovolemia Ask about PET symptoms ```
44
How is the diagnosis of placental rupture made
Clinical diagnosis- do not need USS to confirm
45
Examination of placental rupture
General maternal well-being->BP, pusle, T, 02 sats Abdominal examination->tonic contractions->hard, tender uterus Must exclude HTN and proteinuria due to association with pre-eclampsia Check for liver tenderness, hyperreflexia and clonus
46
Investigations in placental abruption
FBC, UEC, LFT, coags, Blood group and hold, Xmatch, Rh status (anti-RhD), urinalysis, Lkei CTG, USS of limited valuue->if clinical diagnosis
47
Management of placental abruption
As for placenta praevia->dependant on severity of bleeding
48
Risk of recurrence of placental abruption in next pregnancy
8%
49
How is the blood loss in vasa previa different from the blood loss in PP and placental abruption
The blood lost from vasa previa is from the fetus->needs urgent delivery before the fetus exsanguinates
50
Management if coagulopathy
give 4 units FFP, have 6 units PLTs ready Usually resolves 4-6 hours after delivery
51
Can an epidural be given in placental abruption
No, risk of coagulopathy

Obstetrics and Gynaecology (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions