bleeding disorders Flashcards by KENITH V. LAGO

HYPOVOLEMIC SHOCK
blood loss amounting to

1.5 –2 L.

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Hemorrhage - occurs
during pregnancy, labor & delivery

Perinatal

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anytime
during pregnancy

Antepartal hemorrhage

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termination of pregnancy
before 12 weeks (fetus is
< 500gms)

Early abortion

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termination of pregnancy occurs
between 12 to 20 weeks

Late abortion

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1st trimester bleeding:

Abortion & Ectopic
Pregnancy

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2nd trimester bleeding:

Hydatidiform Mole &
Incompetent Cervix

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3rd trimester: bleeding:

Placenta previa
& Abruptio Placenta

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by personal
choice type of Abortion

Elective abortion

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due to natural
causes; unexpected ending of
pregnancy

Spontaneous Abortion

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4 stages of abortion

Threatened abortion

Inevitable abortion

Incomplete abortion

Complete abortion

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one of the causes of abortion is the inadequate production of what hormone

progesterone

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occurs when clotting occurs in placental vessels and It blocks placental growth

Antiphospholipid Antibody Syndrome

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Prophylaxis to Prevent
Miscarriages

Oral low-dose aspirin
Heparin (SQ)

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If heparin & aspirin alone are not
adequate for APS, what is administered

IV immunoglobulin
infusion or corticosteroid
administration

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Possible loss of the
products of conception.

THREATENED ABORTION

Light vaginal bleeding
(scanty, bright red)

No cervical dilatation

None to mild uterine
cramping

THREATENED ABORTION

MANAGEMENT FOR THREATENED ABORTION

Conservative management

HCG monitoring

Conservative Management
of Threatened Abortion

no medical therapy
Bedrest until 3 days
Hormonal Therapy

loss of the product of
conception that cannot be
prevented.

INEVITABLE OR
IMMINENT ABORTION

Moderate to profuse bleeding

Moderate to severe uterine
cramping

Open cervix or dilatation of
cervix

INEVITABLE OR
IMMINENT ABORTION

MANAGEMENT FOR INEVITABLE OR
IMMINENT ABORTION

Vacuum Extraction or

Dilatation & Curettage
Dilatation & Evacuation

Oxytocin after D&C

Spontaneous expulsion of the products of
conception.

COMPLETE ABORTION

Light bleeding or some blood

No tenderness in the cervix, uterus, or abdomen

None to mild uterine cramping

Closed cervix

Empty uterus on ultrasound

COMPLETE ABORTION

Heavy vaginal bleeding Severe uterine cramping Open cervix Passage of tissue

INCOMPLETE ABORTION

Retention of all products of conception after the death of a fetus in the uterus.

MISSED ABORTION

Absence of Fetal Heart Tone (FHT) Signs of early pregnancy symptoms disappearing, e.g., nausea & breast soreness

SIGNS & SYMPTOMS

MANAGEMENT FOR MISSED ABORTION

inserting 20mg dinoprostone vagina q 3 or 4 hrs. Dilute IV infusion of oxytocin to expel conceptus.

Infection complicates the dissemination of bacteria & toxins into the maternal circulatory and organ systems.

SEPTIC ABORTION

SIGNS & SYMPTOMS : SEPTIC ABORTION

Foul - smelling vaginal discharge Uterine cramping Fever, chills & peritonitis Leukocytosis – WBC count, 16,000 to 22,000/uL

Critically ill patients may have evidence of septic or endotoxic shock with vasomotor with this type of abortion

SEPTIC ABORTION

Hypothermia, Hypotension Oliguria or anuria and Respiratory distress are common in this type of abortion

SEPTIC ABORTION

MANAGEMENT FOR SEPTIC ABORTION

High dose of antibiotic therapy Penicillin for gram (-) microorganisms Clindamycin & tobramycin for gram (+) D&C

administered to maintain sufficient cardiac output

Dopamine & digitalis