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Flashcards in deck_5527472 Deck (25)
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1
Q

What is a bloody show?

A

Cervical dilation during normal labor is commonly accompanied by a small amount of blood or blood-tinged mucus

2
Q

T or F. Digital examination should be done to diagnose third trimester bleeding until ultasound excludes a placenta previa

A

T. However, a steril speculum exam can be performedbefore ultrasound

3
Q

What test can be performed to calculate the appropriate dose of Rhogam to give to a Rh- mother at 28 weeks gestation?

A

Kleihauer-Betke test

4
Q

What is placenta previa?

A

This is when the palcenta implants into the decidua near or overlying the internal cervical os

5
Q

What things increase the risk of placenta previa?

A

age, smoking, and previous C-sections

6
Q

Describe the prevelance and normal progression of placenta previa

A

They are a common incidental finding in a second trimester ultrasound but he vast majority regress by birth

7
Q

T or F. A tranvaginal ultrasound is safe in a suspected placenta previa

A

T.

8
Q

Why does placenta previa tend to resolve spontanoeusly so commonly?

A

Due to growth of the placental trophoblasts toward the fundus, with its richer blood supple and the development or elongation of the lower uterine segment

9
Q

How does symptomatic placenta previa typically present?

A

vaginal, painlessbleeding in the late second or third trimester, often after sexual intercourseNOTE: this bleeding is not usually sufficient to hurt the mother or the fetus

10
Q

Most neonatal morbidity and mortality associated with placenta previa results from what?

A

complications of prematurity (so the main therapeutic strategy for placenta previa is to prolong the pregnancy until fetal lung maturity is achieved, typically via the use of tocolytic agents or cervical creclage)

11
Q

The likelihood of a previa persising until term increases if the previa is _________

A

complete, or presents initially at a later gestaitional age, or if there is a Hx of C-section

12
Q

T or F. The length of placental to internal cervical os overlap is highly correlated to the risk of previa presistence to term

A

T.

13
Q

Women with asymptomatic previa in the second trimester can continue normal activities until follow-up ultasound is performed at 28 weeks and women with persistent previa in the third trimester should report any bleeding and abstain from intercourse and use of tampons

A

Becuase previa can resolve close to erm, its reccommendd that no decision on mode of delivery be made until after ultrasound at 36 weeks

14
Q

Note that the closer a persistent previa is the internal cervical os, the more likely that a C-section will likely have to be performed

A
15
Q

T or F. The risks for placenta accreta, increta, and percreta increase with increased number of previous C-sections

A

T.

16
Q

What is placental abruption?

A

the seperation of the placenta from the uterine wall before delivery

17
Q

What are the risk factors associated with placental abruption?

A

tobacco or cocaine use, chronic HTN, preeclampsia, abdominal truama and previous abruption

18
Q

What is a common complication ofabruption of the placenta?

A

DIC can result from the release of thromboplastin into the maternal circulation

19
Q

T or F. Definitive management of an abrupted placenta should neber ne delayed for ultrasound confirmation

A

T. B/c ultrasound is not reliable in diagnosing abruption

20
Q

Tocolytics are generally contraindicated in placental abruption except in mild abruption before 34 weeks gestation

A
21
Q

When fetal death occurs secondary to abruption, _____ delivery should the goal

A

vaginal

22
Q

What things can decrease the risk for placental abruption?

A

cessation of tobacco, cocaine, or amphetamine use, and appropriate care for HTN disorders of pregnancy

23
Q

What is vasa previa?

A

When the umbilical vessels wrap around the fetus in such a way as to be susceptible to breaking through rupturing of the fetal membranes

24
Q

The hemorrhage that occurs with vasa previa belongs to who?

A

the fetus- exsangunation can occur rapidly!

25
Q

How would screening for vasa previa occur?

A

transvaginal color-flow Doppler to ID the presence of vessels in the fetal membranes