Midterms Bleeding Disorders in Pregnancy

Question 1

This is rapid loss of more than 1% of body weight
- deprivation of glucose & oxygen in the tissues
- build-up of waste products

Answer 1

Hemorrhage

Question 2

blood loss amounting to 1.5 – 2 L.

Answer 2

HYPOVOLEMIC SHOCK

Question 3

rapid blood loss results in

Answer 3

inadequate tissue perfusion

Question 4

A type of hemorrhage that occurs during pregnancy, labor & delivery

Answer 4

Perinatal Hemorrhage

Question 5

A hemorrhage that occurs anytime dring pregnancy

Answer 5

Antepartal hemorrhage

Question 6

A type of hemorrhage that occurs during labor

Answer 6

Intrapartal hemorrhage

Question 7

What is early and late abortion?

Answer 7

• Early abortion (termination before 12 weeks)
• Late abortion (termination between 12-20 weeks)

Question 8

Different Bleeding Disorders of Pregnancy during 1st trimester

Answer 8

Abortion & Ectopic Pregnancy

Question 9

Different Bleeding Disorders of Pregnancy during 2nd trimester

Answer 9

Hydatidiform Mole & Incompetent Cervix

Question 10

Different Bleeding Disorders of Pregnancy during 3rd trimester

Answer 10

Placenta previa & Abruptio Placenta

Question 11

4 Types of abortion

Answer 11

• Elective or Therapeutic Abortion - deliberate
• Elective abortion - by personal choice
• Therapeutic abortions - recommended by MD to protect mental & physical health
• Spontaneous Abortion - due to natural causes; unexpected ending of pregnancy

Question 12

• A syndrome of Abnormal proteins (antiphospholipid autoantibodies) initiate coagulation
  leading to clotting in arteries & veins.
• interfere with oxygen and nutrients.

Answer 12

Antiphospholipid Antibody Syndrome (APS)

Question 13

SIGNS & SYMPTOMS of threatened abortion:

Answer 13

• Light vaginal bleeding (scanty, bright red)
• No cervical dilatation
• None to mild uterine cramping
• More severe cramps may lead to inevitable abortion

Question 14

SIGNS & SYMPTOMS INEVITABLE OR IMMINENT ABORTION

Answer 14

• Moderate to profuse bleeding
• Moderate to severe uterine cramping
• Open cervix or dilatation of cervix
• Rupture of membranes
• No tissue has passed yet

Question 15

The POSSIBLE LOSS of the products of conception.

Answer 15

THREATENED ABORTION

Question 16

THE LOSS of the product of conception that cannot be prevented.

Answer 16

INEVITABLE OR IMMINENT ABORTION

Question 17

The Spontaneous expulsion of the products of conception.

Answer 17

COMPLETE ABORTION

Question 18

The Expulsion of SOME PARTS & retention of other parts of conceptus in utero.

Answer 18

INCOMPLETE ABORTION

Question 19

RETENTION of all products of conception AFTER the death of a fetus in the uterus.

Answer 19

Missed abortion

Question 20

Infection involving the products of conception & the maternal reproductive organ.

Answer 20

INFECTED ABORTION

Question 21

Danger signs of infection:

Answer 21

• fever
• abdominal pain or tenderness, & foul vaginal discharge.

Question 22

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

Answer 22

SEPTIC ABORTION

Question 23

A pregnancy that happens outside the UTERUS.

Answer 23

Ectopic Pregnancy

Question 24

Most common site (95%) of implantation in ectopic pregnancy

Answer 24

Tubal

Question 25

A benign disorder of the placenta characterized by degeneration of the chorion & death of the embryo.

Answer 25

Hydatidiform Mole

Question 26

They create a non-cancerous tumor (like tiny water-filled sacs, similar to a cluster of grapes) instead of a placenta.

Answer 26

Hydatidiform Mole

Question 27

Types of molar pregnancy

Answer 27

Complete Molar - Sperm fertilizes an empty egg; Embryo can’t grow Partial Molar - Two sperm fertilized one egg; Embryo develops but can’t survive

Question 28

HCG levels rise rapidly during what trimester

Answer 28

1st Trimester

Question 29

Characterized by persistent trophoblastic proliferation after H-mole evacuation

Answer 29

GESTATIONAL TROPHOBLASTIC TUMORS

Question 30

Management of all trophoblastic tumor

Answer 30

Hysterectomy

Question 31

3 kinds of Hmole

Answer 31

- Choriocarcinoma – most severe malignant complication; requires chemotherapy or radiation. - Invasive Mole – locally invasive developing during the 1st six months - Placental Site Trophoblastic

Question 32

Premature separation of normally transplanted placenta after 20 weeks of gestation & before delivery of the fetus.

Answer 32

Abruptio Placenta

Question 33

Types Based on Placental Separation

Answer 33

Partial placental abruption - placenta does not completely detach from the uterine wall. Complete or total placental abruption - placenta completely detaches from the uterine wall— more vaginal bleeding.

Question 34

Classifications Based on Signs & Symptoms

Answer 34

- Grade 0 – NO symptoms - Grade 1 – SOME EXTERNAL BLEEDING, uterine tetany & tenderness (may/may not be noted), absence of fetal distress & shock (minimal separation). - Grade 2 – EXTERNAL BLEEDING, uterine tetany, uterine tenderness, & fetal distress (moderate separation) - Grade 3 – INTERNAL & EXTERNAL BLEEDING (more than 1000cc), uterine tetany, maternal shock, probably fetal death & DIC (extreme separation).

Question 35

Colors depending on the types of AP

Answer 35

dark red – concealed AP bright red – revealed AP

Question 36

True or false? If the abruption is SEVERE and the mother or the fetus is at risk,

Answer 36

True

Question 37

the placenta completely or partially covers the uterus (cervix) opening in the last mont

Answer 37

Placenta Previa

Question 38

Types of Placenta Previa

Answer 38

Marginal placenta previa - placenta is positioned at the edge of the cervix. - more likely to resolve on its own Partial placenta previa - placenta partially covers the cervix. Complete or total placenta previa - placenta is completely covering your cervix, blocking the vagina. - less likely to correct itself

Question 39

most significant sign of placenta previa

Answer 39

Sudden painless vaginal bleeding (begins 24-30 weeks)

Question 40

Management & Treatment of placenta previa

Answer 40

- get the mother as close to the due date as possible. - Delivering a C-section