W11_07 Intrapartum care, abnormal labour, obstetrical emergencies 2 Flashcards Preview

MMMD 2 > W11_07 Intrapartum care, abnormal labour, obstetrical emergencies 2 > Flashcards

Flashcards in W11_07 Intrapartum care, abnormal labour, obstetrical emergencies 2 Deck (19)
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1
Q

what’s a succenturitae lobe?

A

an accessory lobe of the placenta;
note this can be a risk factor for vasa previa b/c of the connecting bridge

2
Q

note: it’s the lower uterus that grows the most in the 3rd trimester

A

if placenta is here, it can be sheared off and cause bleeding

3
Q

what’s placenta acreta?

A

villi Attach to the myometrium

4
Q

what’s placenta increta?

A

villi Invade into the myometrium

5
Q

what’s placenta percreta?

A

villi Penetrate through the myometrium (e.g. into bladder)

6
Q

what’s a sentinel bleed?

A

bleeding in the third trimester that stops spontaneously, and may indicate a placenta previa

7
Q

define primary postpartum hemorrhage

A

excessively bleeding 24h after delivery;
500mL loss after vaginal;
1000mL loss after c-section

8
Q

define secondary postpartum hemorrhage

A

bleeding 24h to 6 weeks postpartum

9
Q

what are causes of PPH? (4 Ts)

A

tone;
trauma;
tissue;
thrombin

10
Q

risk factors of poor tone, causing PPH?

A

overdistension of uterus;
uterine fatigue;
previous PPH;
infection;
anatomic distortion;
medications (nitroglycerin, anesthetics)

11
Q

what are the 4 signs of placental separation?

A

gush of blood;
cord lengthening;
uterus becomes globular;
uterus rises in abdomen

12
Q

what’s the most important part of PPH prevention?

A

prophylactic oxytocin before or after placental delivery

13
Q

what’s the most important and effective intervention of PPH?

A

bimanual massage - compress the uterus with both hands

14
Q

what are some uterotonics for medical PPH treatment?

A

oxytocin,
ergonavine (no for HTN or pre-eclampsia),
hemabate (no for asthmatics),
misoprostol

15
Q

what are some clotting agents used in PPH?

A

tranexamic acid (antifibrinolytic);
recombinant activated factor VII

16
Q

what’s a bakri balloon?

A

like a foley, but way bigger balloon and is inserted into uterus to tamponade during PPH

17
Q

what are some radiologic interventions of PPH?

A

uterine artery embolization w/catheter

18
Q

what are some surgical interventions of PPH?

A

compression sutures (B-lynch);
selective ligation of uterine vessels;
ligation of internal iliac;
hysterectomy

19
Q

what’s sheehan syndrome?

A

anterior pituitary becomes necrotic due to hypovolemia. Can cause lack of prolactin or amenorrhea, etc, after PPH

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