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FINALS - OBS, GYNAE, BREAST > bleeding in pregnancy > Flashcards

bleeding in pregnancy Flashcards

(48 cards)

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1
Q

symptoms threatened miscarriage

A

painless bleeding 6-9 weeks

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2
Q

symptoms incomplete miscarriage

A

heavy bleeding and cramping, lower abdo pain

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3
Q

symptoms missed miscarriage

A

little vaginal bleeding and pregnancy symptoms subside

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4
Q

symptoms ectopic

A

6-8 weels amenorrhea –> light bleeding // severe unilateral abdo pain // shoulder tip pain // cervical excitation

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5
Q

symptoms molar pregnancy

A

bleeding in fist trimester, extreme pregnancy symptoms, large for dates uterus, v high hCG

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6
Q

what is an antepartum haemorrhage

A

bleeding from 24 weeks

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7
Q

most common causes APH

A

placental abruption and placenta praevia

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8
Q

what is placental abruption

A

normally sited placenta detaches from uterine wall –> maternal haemorrhage

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9
Q

assoc placental abruption

A

pre-eclampsia // cocaine // multiparity // trauma // maternal age

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10
Q

features placental abruption

A

shock out of keeping with loss // multuparity // trauma // age

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11
Q

features uterine rupture

A

shock // continuous pain // tender, tense uterus !! // abnormal foetal heart // coagulation problems // pre-eclampsia, DIC, anuria

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12
Q

mx placental abruption if fetus alive and <36 weeks

A

distress = C section // no distress = admit and observe, steroids

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13
Q

mx placental abruption if fetus alive and >36 weeks

A

distress = c section // no distress = vaginal

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14
Q

mx placental abruption if fetus dead

A

vaginal delivery

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15
Q

maternal complications placental abruption

A

shock, DIC, renal failure, PPH

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16
Q

maternal complications placental abruption

A

shock, DIC, renal failure, PPH

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17
Q

fetal complications placental abruption

A

IUGR, hypoxia, death

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18
Q

what is placenta praevia

A

placenta lying wholly or partly in lower uterine segment (covering or within 20mm os)

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19
Q

when is placenta praevia diagnosed

A

20 week scan

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20
Q

RF Placenta praevia

Study These Flashcards
A

previous c section or scars!! multi-parity, twins, TOP, >40

21
Q

symptoms Placenta praevia

Study These Flashcards
A

shock (expected) // NO pain // uterus non tender // fetal heart usually normal

22
Q

invx Placenta praevia

Study These Flashcards
A

do NOT perform digital exam until USS // transvaginal USS

23
Q

grading Placenta praevia

Study These Flashcards
A

I = placenta reaches lower segment but not internal os // II = reaches os but does not covert it // III = covers internal os (not when dilated) // IV = completely covers

24
Q

further invx if Placenta praevia diagnosed

Study These Flashcards
A

rescan at 32 weeks –> rescan every 2 weeks –> final scan at 36-37 weeks

25
delivery placenta praevia
grades III/IV = c section between 37-38 weeks
26
mx if pregnant women with known Placenta praevia goes into spontaneous labour
emergency C section (with or without bleeding)
27
what is vasa praevia
unprotected foetal vessels over internal os
28
diagnosis vasa praevia
USS
29
symptoms vasa praevia
sudden, painless, dark bleeding after rupture of membrane
30
mx vasa praevia
<34 weeks steroids // 34-36 deliver // emergency C section
31
RF uterine rupture
prolonged labour!!! // IOL, previous rupture, previous C section, raised BMI
32
symptoms uterine rupture
severe abdo pain // PV bleeding // loss of contractions // hypotension + tachycardia // presenting part retracts back into vagina
33
mx uterine rupture
C section
34
what defines PPH
blood loss >500ml vaginally // >1L C section
35
what is a primary vs secondary PPH
primary = within 24 hours // secondary = 24 hours - 6 weeks
36
most common causes primary PPH
4 Ts: uterine aTony!!!! // trauma // tissue // thrombin (bleeding or clotting disorder)
37
RF PPH
previous PPH // prolonged labour // pre-eclampsia // increased age // polyhydramnios // emergency c section // placenta problems // macrosomnia
38
ABC mx PPH
lie women flat // group and save // crystalloid infusion
39
ABC mx PPH
lie women flat // group and save // crystalloid infusion
40
mechanical mx PPH
palpate fundus internally + catheterise patients
41
medical mx PPH
IV oxytocin // IV or IM ergometrine // IM carboprost // sublinguinal misoprostol
42
surgical mx PPH
intrauterine balloon tamponade
43
what causes secondary PPH
retained POC or endometritis (infection)
44
what is placenta accreta
placenta adheres too far into uterus --> myometrium
45
symptoms placenta accreta
PPH
46
diagnosis Placenta accreta
MRI
47
RF Placenta accreta
previous C section, placenta praevia
48
placenta accreta, increta, percreta
accreta: attach TO myometrium // increta: invade INTO myometrium // pecreta = THROUGH perimetrium

FINALS - OBS, GYNAE, BREAST (27 decks)

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