Placental Complication Focused

Question 1

The umbilical cord consists of: __________ which carry __________blood

and
__________

Answer 1

The umbilical cord consists of: TWO ATERIES which carry UNOXYGENATED blood

and

ONE VEIN.

Question 2

what is PLACENTA PREVIA?

Answer 2

PLACENTA PREVIA is when the placenta is improperly implanted in the lower uterine segment

Question 3

how is PLACENTA PREVIA identified/characterized?

Answer 3

PLACENTA PREVIA is characterized by painless, bright red bleeding after 20 weeks

Question 4

Can you have a VAGINAL delivery with PLACENTA PREVIA?

Answer 4

NOOO! Placenta previa will NEVER result in a vaginal delivery!

Question 5

What factors put a mother/baby at risk for PLACENTA PREVIA?

Answer 5

Male fetus
large placenta
Asian race
Advanced maternal age >35
Prior occurrence
Multi-fetal gestation
Smokes
Previous surgical delivery

Question 6

Marginal placenta previa

Answer 6

Placenta is towards the side of the uterus, but covers the cervix, vaginal opening!

Question 7

Complete placenta previa

Answer 7

Placenta is lying directly over the cervix, vaginal opening

Question 8

Low-lying placenta previa

Answer 8

Placenta is lying low, very close to the cervix, vaginal opening.

Question 9

Symptoms of expectant placenta previa usually occur before ________ gestation and include a __________ with __________

Answer 9

Symptoms of expectant placenta previa usually occur before 36 WEEKS gestation and include a NORMAL FHR with MILD BLEEDING

Question 10

Symptoms of active placenta previa include:

Answer 10

excessive bleeding
fetal distress
uterine infection

Question 11

Women with placenta previa are at high risk for __________ because the lower half of the uterus is unable to contract.

Answer 11

Women with placenta previa are at high risk for POSTPARTUM HEMORRHAGE because the lower half of the uterus is unable to contract.

Question 12

__________ is the premature separation of a normally implanted placenta.

Answer 12

PLACENTAL ABRUPTION is the premature separation of a normally implanted placenta.

Question 13

__________ is characterized by dark red vaginal bleeding, abdominal pain, uterine tenderness, and contractions after 20 weeks.

Answer 13

PLACENTAL ABRUPTION is characterized by dark red vaginal bleeding, abdominal pain, uterine tenderness, and contractions after 20 weeks.

Question 14

The highest risk for placental abruption are women with ________ during pregnancy

Answer 14

The highest risk for placental abruption are women with HYPERTENSION during pregnancy

Question 15

The #1 acute risk for placental abruption is __________ because it causes a rapid increase in __________

Other causes are __________
and __________

Answer 15

The #1 acute risk for placental abruption is COCAINE USE because it causes a rapid increase in BLOOD PRESSURE

Other causes are CAR WRECKS
and DOMESTIC VIOLENCE

Question 16

An expectant placental abruption is a _______________________

Answer 16

An expectant placental abruption is a POTENTIAL EMERGENCY.

Question 17

An active placental abruption is an ________________________

Answer 17

An active placental abruption is an ACTUAL EMERGENCY

Question 18

What is expected for an active placental abruption?

Answer 18

Vaginal delivery is PERFERRED; both mom and babies life are in jeopardy.

Question 19

What is WHARTON’S JELLY?

Answer 19

WHARTON’S JELLY is mucoid connective tissue that surrounds the vessels within the umbilical cord!

Question 20

What is VASA PREVIA

Answer 20

VASA PREVIA occurs when the blood vessels of the umbilical cord are not covered in Wharton’s jelly so they become susceptible to rupture.

Question 21

What is NUCHAL CORD

Answer 21

NUCHAL CORD means the cord is wrapped around the neck

Question 22

What is a TRUE KNOT?

Answer 22

TRUE KNOT is a common cause for still born births; most common in twins who share an amniotic sac

A super active baby with a long cord is also at high risk

Question 23

__________ or ___________ is when there is no fetus but trophoblast developed abnormally

Answer 23

HYDATIDIFORM MOLE or GESTATIONAL TROPHOBLASTIC DISEASE is when there is no fetus but trophoblast developed abnormally

Question 24

A woman with Hydatidiform Mole / Gestational Trophoblastic Disease has to have a __________ every month. __________ should drop every month.

Answer 24

A woman with Hydatidiform Mole / Gestational Trophoblastic Disease has to have a PREGNANCY TEST every month. HCG LEVELS should drop every month.

Question 25

A woman with Hydatidiform Mole / Gestational Trophoblastic Disease must be told that she absolutely CANNOT __________

Answer 25

A woman with Hydatidiform Mole / Gestational Trophoblastic Disease must be told that she absolutely SHOULD NOT BECOME PREGNANT WITHIN 1 YEAR

Question 26

dizygotic twins (fraternal)

Answer 26

two separate babies from the beginning; 2 placentas

Question 27

monozygotic twins (identical)

Answer 27

starts as 1, splits to two; shares placenta

Question 28

Placenta previa is characterized by bright painless bleeding after 20 weeks gestation. True or false.

Answer 28

TRUE

Question 29

What are the risk factors for placenta previa? Select all that apply. ``` Exercises Smokes Large placenta Previous surgical delivery Advanced maternal age ```

Answer 29

Smokes Large placenta Previous surgical delivery Advanced maternal age

Question 30

A woman has a surgical delivery due to placenta previa. Her contracted uterus after surgery will prevent uterine hemorrhage. True or false.

Answer 30

False Since the lower uterine segment does not contract, she may still hemorrhage with a firm fundus.

Question 31

Placental abruption describes the condition where the placenta completely separates from the uterine wall. True or false.

Answer 31

False Placental abruption may describe a complete separation of the placenta from the uterine wall but can also describe a partial separation

Question 32

When vasa previa occurs, the fetal vessels are covered in Wharton's jelly. True or false.

Answer 32

False In vasa previa, the fetal vessels that connect the umbilical cord to the placenta are not covered in the protective Wharton's jelly. These unprotected vessels may be easily compressed or torn causing fetal hypoxia, hemorrhage and death.

Question 33

A woman who has experienced gestational trophoblastic disease must use a reliable form of __________ for at least 1 year after treatment.

Answer 33

A woman who has experienced gestational trophoblastic disease must use a reliable form of CONTRACEPTION for at least 1 year after treatment. ***pregnancy must be avoided for 1 year after treatment for gestational trophoblastic disease.

Question 34

A woman being actively managed for placental abruption receives an indwelling catheter to keep the bladder empty. True or false.

Answer 34

False A woman experiencing active management for placental abruption, which indicates moderate to severe vaginal bleeding, receives an indwelling catheter to assess maternal organ perfusion.

Question 35

What are the risk factors for abnormal placental attachment? Select all that apply. ``` irregular menses previous surgical delivery retroverted uterus 35 years of age or older smoking ```

Answer 35

35 years of age or older smoking previous surgical delivery

Question 36

Nuchal cord is a serious and rare occurrence in vaginal deliveries. True or false.

Answer 36

False nuchal cord with 1 loop occurs in about 30% of births and is reduced by the provider of care.