Previa / Accreta / Abruption

Question 1

How to diagnose antepartum hemorrhage

Answer 1

Sonography
Avoid digital penetration
Pain in abruption
Painless in Previa

Question 2

Previa is associated with

Answer 2

increasing age, multiparity, multiple prior C/S

Question 3

Previa types

Answer 3

Partial vs Total (covers OS)

Low lying placenta is not previa

Question 4

OB management of previa and antepartum bleed

Answer 4

If mature fetus then deliver
If not mature
- watch with ultrasound, hgb, VS
- betamethasone (steroid) to accelerate lung 24-34 wks
- tocolytic if laboring
- elective c/s at 36 wks if lungs mature

Question 5

What is vaso previa

Answer 5

when fetal vessels are outside of placenta/cord. high mortality if not diagnosed

Question 6

Abruption risks

Answer 6

HTN (gestational, chronic, preclampsia), increasing age, parity

Question 7

Complications from bleeding disorders of pregnancy

Answer 7

• Shock, coagulopathy, DIC, Sheehan, fetal death, ARF

Question 8

Uterine rupture risk and tx

Answer 8

prior c/s. Partial vs Complete

tx with c/s

Question 9

Accreta types, dx, mgmt

Answer 9

Accreta - myometrium
Increta - into myometrium
Percreta - through myometrium
dx - ultrasound
mgmt - elective c/s when lungs mature

Question 10

Fetal lung maturity testing

Answer 10

amniotic fluid - measures surfactant made by type II aveolar cells
Give betamethasone 24-34 wks