OBGYN & BURN Flashcards
(171 cards)
Identify A B C and D

A. Normal (Decidua)
B. Increta (17%)
C. Percreta (5%)
D. Accreta (75-78%)
Describe what the image shows

Placenta Increta
- Placenta invasion to myometrium
- Leads to massive bleeding after delivery
Describe what the image shows

Placenta Accreta
- Placenta adhesion to uterine myometrium without invasion
- Leads to massive bleeding after delivery
Identify A B and C

A: Marginal placenta previa.
B: Partial placenta previa.
C: Complete placenta previa.
Identify A and B

A. Apparent bleeding from premature separation
B. Concealed bleeding from premature separation
Placenta adhesion to uterine myometrium without invasion leading to massive bleeding after delivery
Placenta Accreta
Placenta acreta is likely to occur in patients with a history of?
- previous C/S
- placenta previa,
- uterine trauma
Placenta invasion to myometrium that leads to massive bleeding after delivery
Placenta Increta
placenta invasion to myometrium, serosa and adjacent pelvic structures
Placenta Percreta
There are 3 types of placental abnormal implantations, placenta acreta, increta and percreta. How are they diagnosed and managed
Dx: U/S. MRI
Management: C/S or postpartum hysterectomy
The two MCC of 3rd trimester bleeding are?
Placenta previa and placental abruption
Placenta previa is?
abnormally implanted placenta on the lower uterine segment and covers or borders on the cervical os.
Identify 3 types of placenta previa
- Marginal – within 2 cm of os
- Total – completely covers os ( C section)
- Partial – partially covers os ( C section)
The Overall incidence and mortality of Placenta previa is?
1%
What are the risk factors of placenta previa
- Large placenta
- Accreta
- Previous C/S
- Multipara
- Malpresentation
- Advance maternal age
Do NOT do a vaginal exam for this patient
Patient with placenta previa
What are the signs and symptoms of a patient with placenta previa and how is it diagnosed?
- Painless vaginal bleeding which stops automatically
- Preterm labor
- Maternal hemorrhage with hypotension
- Diagnosed with U/S, MRI
This patient should always have a C-section delivery
Patient with placenta previa
What is the most common cause of neonatal motality and mobidity?
Placenta Previa
Describe the management of a patient with placenta previa
1.Expectant (wait till delivery)
–Hospitalization; bed rest and observation if < 37 weeks with mild to moderate bleeding
–I/V fluids , typing & cross matching
–Maintain crit > 30
–Await lung maturity ( steroid shots)
- Coagulopathy is common; may need replacement
- Delivery
–Do L/S ratio, if immature give steroid to mom
- Always C/S
Patient with placenta previa has an abnormal L/S ratio. What would you do?
Give steroids to the mother
The lecithin–sphingomyelin ratio is a test of fetal amniotic fluid to assess for fetal lung immaturity
What are the complications of Placenta previa
- Premature delivery – most common cause of neonatal M&M
- Placenta accreta – do Hystrectomy
- PPH
This occurs when the normally implanted placenta separates from decidua basalis prior to delivery, bleeding may be overt or concealed.
Abruptio Placenta
What are the risk factors of placenta abraptio
- Maternal hypertension
- Cocaine , smoking M
- Trauma
- Preterm premature rupture of membranes
- Hypertonic uterus
- Previous history





