Bleeding in pregnancy

Question 1

what is antepartum haemorrhage defined as?

Answer 1

bleeding after 24 weeks

Question 2

what are the common causes of bleeding in the 1st trimester

Answer 2

Spontaneous abortion
Ectopic pregnancy
Hydatidiform mole

Question 3

what are the common causes of bleeding in the 2nd trimester?

Answer 3

Spontaneous abortion
Hydatidiform mole
Placental abruption

Question 4

what are the common causes of bleeding in the 3rd trimester?

Answer 4

Bloody show
Placental abruption
Placenta praevia
Vasa praevia

Question 5

other than pregnancy related causes what else should be considered

Answer 5

stis

cervical polyps

Question 6

types of spontaneous abortions

Answer 6

threatened

missed/delayed

inevitable

incomplete

complete

Question 7

what is the bleeding like in a threatened miscarriage and when does it occur?

Answer 7

painless vaginal bleeding

typically around 6-9 weeks

Question 8

what is the bleeding like in a missed/delayed miscarriage?

Answer 8

light vaginal bleeding

symptoms of pregnancy disappear

Question 9

what is the bleeding like and pain like in an incomplete miscarriage?

Answer 9

heavy bleeding and crampy, lower abdo pain

Question 10

what is the bleeding like in a complete miscarriage?

Answer 10

little bleeding

Question 11

what is a typical history for an ectopic pregnancy?

Answer 11

Typically history of 6-8 weeks amenorrhoea with lower abdominal pain (usually unilateral) initially and vaginal bleeding later.

shoulder tip pain

Question 12

is cervical excitation present in an ectopic?

Answer 12

yes

Question 13

when does bleeding occur with a hydatidiform mole?

Answer 13

Typically bleeding in first or early second trimester

Question 14

what are the symptoms of pregnancy like with a hydatidiform mole?

Answer 14

exaggerated - e.g. hyperemesis

Question 15

what is the uterus like in a hydatidiform mole?

Answer 15

large

Question 16

what is the serum hCG like with a hydatidiform mole?

Answer 16

very high

Question 17

what are the symptoms and signs of placental abruption?

Answer 17

Constant lower abdominal pain and, woman may be more shocked than is expected by visible blood loss.

Tender, tense uterus* with normal lie and presentation.

Question 18

what happens to the foetal heart in placental abruption?

Answer 18

maybe distressed

Question 19

what are the symptoms of placental praevia?

Answer 19

vaginal bleeding

no pain

non-tender uterus but lie and presentation maybe abnormal

Question 20

what is vasa praevia?

Answer 20

Rupture of membranes followed immediately by vaginal bleeding.

Question 21

what is happens to the foetal heart rhythm is vasa praevia?

Answer 21

bradycardia