MCH-BLEEDING DISORDERS

Question 1

When the fertilized ovum implants outside the uterine cavity, usually in the fallopian tube
May have lower abdominal pain with light bleeding. Bleeding may be contained within the abdomen
Watch for signs of hypovolemic shock

Answer 1

Ectopic Pregnancy

Question 2

When the **chorionic villi **increase abnormally and develop vesicles
May result in hemorrhage, clotting abnormalities, and hypertension. Increased risk for choriocarcinoma later in life
Rapid uterine growth, failure to detect fetal heart activity, higher than normal hCG levels

Answer 2

Hydatidiform Mole

Question 3

May be marginal, partial, or total
Low lying is implanted near the cervix but does not cover the opening, not a true previa
Painless vaginal bleeding, usually bright red
Risk of hemorrhage increases as due date approaches, and the cervix begins to dilate and efface
Possible C/S due to abnormal presentation (placenta occupies lower uterus) and risk of bleeding if dilation occurs
Risk of infection due to ease of organisms to reach the placental site. Risk of hemorrhage due to fewer muscle fibers to contract in the lower section of the uterus
Monitor FHR, infant is as risk for anemia or hypovolemic shock, and respiratory distress

Answer 3

placenta previa

Question 4

Premature separation of the placental from the uterine wall, may be partial or total
S&S include bleeding with abdominal or low back pain
Tender and unusually firm uterus (board-like)
Bleeding may be concealed, if visible blood will be dark red
DIC is common as the large blood clot that forms behind the placenta consumes maternal clotting factors, increases risk for PPH, also increased risk for infection from damaged tissues
Immediate C/S is necessary to decrease risk of maternal shock, clotting disorders, and fetal death. Fetus may have anemia or hypovolemic shock, may also die before delivery

Answer 4

abruption placentae