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NCM 109 > Bleeding Conditions During Pregnancy > Flashcards

Bleeding Conditions During Pregnancy Flashcards

1
Q

What does Hmole stand for?

A

Hydatidiform Mole

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2
Q

Is it normal to bleed during pregnancy?

A

No

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3
Q

What are the bleeding conditions during 1st Trimester?

A
  • Abortion

- Ectopic Pregnancy

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4
Q

Bleeding conditions during 2nd trimester?

A
  • Hydatidiform Mole

- Incompetent Cervix

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5
Q

Bleeding conditions during 3rd trimester?

A
  • Placenta Previa
  • Abruptio Placenta
  • Preterm Labor
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6
Q

Why is it dangerous to have bleeding during pregnancy?

A
  • Placental Loosening
  • Just a fraction of total bleeding
  • Uterus is a non-essential organ
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7
Q

Termination of pregnancy before the age of viability.

What is the age of viability?

A

Abortion

20-24 weeks AOG

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8
Q

If the baby is less than 500g, what does it mean?

A

Abortus

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9
Q

If the baby is more than 500g, what does it mean?

A

Parity

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10
Q

Causes of spontaneous miscarriage?

A
  • Chromosomal Abnormalities
  • Implantation Problems
  • TORCH Infections
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11
Q

Different types of abortion

A
  • Threatened
  • Imminent
  • Complete
  • Incomplete
  • Missed
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12
Q

What is threatened abortion?

A
  • Will not always lead to abortion
  • No cervical dilation
  • Cramping & Bleeding
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13
Q

What is imminent abortion?

A
  • Will always lead to abortion
  • Cervical dilation
  • Cramping & Bleeding
  • Rupture of Membrane (ROM)
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14
Q

What is complete abortion?

A
  • All products are expelled

- After 2 hrs, bleeding stops

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15
Q

What is incomplete abortion?

A
  • Some products are retained
  • Bleeding continues
  • Dilatation and Curattage
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16
Q

What is missed abortion?

A
  • All products are retained
  • Bleeding will continue
  • Induced pregnancy
  • May develop into Disseminated Intravascular Coagulation
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17
Q

Implantation outside the uterus

A

Ectopic Pregnancy

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18
Q

Where is the common site of implantation inectopic pregnancy?

A

Ampulla

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19
Q

Causes of ectopic pregnancy

A
  • Congenital malformations
  • Adhesions
  • Tumors
  • Scars from previous surgeries
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20
Q

Assessment for ectopic pregnancy

A
  • Sharp stabbing pain in lower quadrant
  • Rigid abdomen
  • Cullen’s Sign
  • Shoulder pain
  • Leukocytosis
  • Signs of SHOCK
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21
Q

If unruptured, what should you give to manage ectopic pregnancy?

A

Methotrexate

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22
Q

If ruptured, what should you do to manage ectopic pregnancy?

A

Salpingectomy or suturing using a micro surgical technique

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23
Q

What procedure is done during Abdominal Pregnancy?

A

Laparotomy

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24
Q

What is Hmole?

A

Abnormal proliferation and Degeneration of trophoblastic cells

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25
Q

A condition wherein the mother is pregnant with no baby. No embryoblast, only trophoblast.

A

Hydatidiform Mole

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26
Q

Who are in risk of Hmole?

A
  • Asians
  • Low-protein Diet people
  • Type A women + Type O men pair
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27
Q

What produces the HCG?

A

Trophoblastic cells

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28
Q

What does HCG do?

A
  • Ensures corpus luteum survives up to 2 months
  • Reverse peristalsis
  • Used to detect pregnancy
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29
Q

Manifestations of Hmole

A
  1. Hyper Emesis Gravidarum
  2. Unusually large abdomen
  3. Grape-like Vesicles
30
Q

Kinds of Hmole

A
  1. Complete Mole

2. Partial Mole

31
Q

Type of Hmole wherein ovum has no chromosomal material. Sperm multiplies its own chromosomal material.

A

Complete Mole

32
Q

Type of Hmole wherein 2 sperms penetrate 1 ovum

A

Partial Mole

33
Q

How many chromosomes are formed in Partial Mole?

A

69 chromosomes

34
Q

How many chromosomes are formed in Complete Mole?

A

46 chromosomes

35
Q

Assessment for Hmole

A
  • Vaginal bleeding with passage of fluid-filled vesicles
  • Rapid uterine enlargement
  • High levels of HCG
  • Marked emesis
  • Snowflake pattern on UTZ
36
Q

What procedure is done to manage Hmole?

A
  • Suction Curettage

- Methotrexate (add Dactinomycin if with metastasis)

37
Q

Refers to the low implantation of the placenta

A

Placenta Previa

38
Q

When does Placenta Previa usually occur?

A

30 weeks AOG

39
Q

Symptoms of Placenta Previa

A

Painless, Bright Red Bleeding

40
Q

Placenta Previa associated factors

A
  • Increased Parity
  • Advanced Maternal Age
  • Past Cesarean Births
  • Past Uterine Curettage
  • Multiple Gestation
41
Q

If indention is severe, this may indicate that the uterus is about to rupture

A

Bandl’s Ring

42
Q

Types of Placenta Previa

A
  • Total
  • Partial
  • Marginal
  • Low-lying
43
Q

Describe Total Placenta Previa

A
  • Totally obstructs the cervix

- Cesarean

44
Q

Describe Partial Placenta Previa

A
  • Partially obstructs the cervix

- Cesarean

45
Q

Describe Marginal Placenta Previa

A
  • Lies on the margins

- NSVD

46
Q

Describe Low-lying Placenta Previa

A
  • Not in the margin but still on lower portion

- NSVD

47
Q

Common risk factors for Placenta Previa

A
  1. Multiple parity
  2. Multiple pregnancies
  3. Scars
48
Q

Management of Placenta Previa

A
  1. No IE
  2. Bed rest
  3. Insert IV gauge 19
49
Q

Premature placental separation while baby is still inside mother’s womb

A

Abruptio Placenta

50
Q

Risk factors of Abruptio Placenta

A
  1. Trauma (short umbilicus)

2. Degeneration of Decidua (caused by cocaine, smoking, advanced maternal age, PIH and chronic hypertension)

51
Q

Abruptio placenta assessment

A
  • May occur late in labor
  • Tenderness upon palpation
  • Heavy - dark red bleeding
  • Couvelaire uterus [rigid uterus]
  • Fetal prognosis depends on the extent of the placental separation
  • Maternal prognosis depends on how promptly treatment can be instituted
52
Q

What is DIC?

A

Disseminated Intravascular Coagulation

53
Q

Acquired disorder of blood clotting

A

Disseminated Intravascular Coagulation

54
Q

What causes DIC?

A
  • Pregnancy Induced Hypertension
  • Retained dead fetus
  • Placenta Previa
  • Abruptio Placenta
55
Q

What test is done during Abruptio Placenta?

A

Test Tube Test

56
Q

In labor prior to 37 weeks

A

Preterm Labor

57
Q

Major causes of Preterm Labor

A
  • Dehydration
  • Urinary Tract Infections
  • Chorioamnionitis
58
Q

What hormones are contained in the Posterior Pituitary Gland?

A
  • Anti-diuretic Hormone

- Oxytocin

59
Q

Hormone which causes the uterus to contract

A

Oxytocin

60
Q

Hormone that stops a person from urinating; conserves fluid

A

Anti-diuretic Hormone

61
Q

Preterm baby risks

A
  • Immunity issues
  • Lungs not fully developed
  • Brain is not mature
  • Testes undescended
62
Q

Signs and indications of Preterm Labor

A
  • Low back pain
  • Uterine contractions
  • Cervical dilation
  • Vaginal bleeding
  • Feelings of pelvic pressure
63
Q

What is the first thing you should do if a pregnant woman comes into the clinic?

A

Ask for AOG

64
Q

Nursing interventions if a woman comes into the clinic

A
  • Put in bed rest

- Insert IV Fluid

65
Q

Theory in which the more the cervix is pressed, the more prostaglandin is released

A

Cervical Pressure Theory

66
Q

What is given to enhance lung maturity (preterm labor)

A

Corticos Steroid or Betamethasone

67
Q

How long until betamethasone takes effect? (preterm)

A

24 hrs

68
Q

This is a smooth muscle relaxant given to mother (preterm)

A

Terbutaline bricanyl

69
Q

Premature cervical dilation

A

Incompetent Cervix

70
Q

Placement of stitches in the cervix to hold it closed (incompetent cervix)

A

Cervical Cerclage

71
Q

What are the two types of cerclage and when is it given?

A
  • Shirodkar cerclage if cesarean

- Mcdonald’s cerclage if NSVD

NCM 109 (1 decks)

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