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14 Cards in this Set
- Front
- Back
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What are the risk factors for Uterine Rupture? (8)
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1. prior uterine surgery/scarring (90%)
2. Injudicious use of oxytocin 3. Grand multiparity 4. Marked uterine distension 5. Abnormal Fetal Line 6. Large fetus 7. External version 8. Trauma |
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What are the primary maternal complications of uterine rupture?
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hemorrhage and hypovolemic shock
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What are signs of uterine rupture?
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1. sudden onset of intense abdominal pain
2. vaginal bleeding (hemorrhage to spotting) 3. nonreassuring fetal testing 4. abnormal abdominal contour 5. cessation of uterine contractions 6. disappearance of fetal heart tones 7. regression of presenting part |
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What is the treatment for uterine rupture?
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1. immediate laparotomy and fetus.
2. repair rupture site and restore hemostasis (or hysterectomy if repair not possible) |
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How would you counsel a patient with a history of uterine rupture regarding future pregnancies?
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advise against it, given a high risk of recurrent rupture. TOL contraindicated and patient would be delivered via cesarean section at 36 weeks with documentation of fetal lung maturity.
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What is the incidence of uterine rupture?
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1:15000 deliveries
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What is vasa previa?
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occurs when the fetal vessels cross over the internal cervical os
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What is velamentous cord insertion?
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occurs when the fetal blood vessels insert between the amnion and chorion away from the placenta.
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what is succenturiate placenta?
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two separate parts of placenta inserted in two different portions of uterus and connected by unprotected vessels, prone to compression, rupture or previa.
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what is a major risk factor for velamentous cord insertion?
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multiple gestations (1% singleton, 10% twins, 50% triplets)
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what is at the top of the DD with vaginal bleeding associated with a sinusoidal variation of FHR indicative of fetal anemia?
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fetal vessel rupture
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What is the Apt test?
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examination of blood for nucleated (fetal) RBCs.
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What is the treatment for fetal vessel rupture?
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emergent cesarean delivery
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What are concerns of delivery in patients with vasa previa?
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patients given option of elective cesarean delivery. If opt for trial of labor, AROM is contraindicated.
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