Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
18 Cards in this Set
- Front
- Back
|
What are some causes of first trimester vaginal bleeding?
|
- miscarriage: chromosome abnormalities, progesterone deficiency
- ectopic pregnancy |
|
|
Types of miscarriages.
|
- blighted ovum: empty embryonic sac
- threatened miscarriage: any bleeding during early pregnancy - inevitable abortion: fetal heart stopped and cervix open - complete abortion - incomplete abortion - missed abortion |
|
|
How do you figure out how much Rhogam you need to give for bleeds during pregnancy?
|
Based on amount of fetal red blood cells
- 300mcg per 15 cc fetal blood cells (deternined by Kleihauer-Betke test) |
|
|
What is the formula to determine fetal blood volume in Kleihauer-Betke test?
|
maternal blood volume (5L) X maternal Hct X % fetal cells
|
|
|
Maternla or fetal hemaglobin?
- resistent to acid solution |
fetal hemaglobin
|
|
|
What is Rosette test?
|
detects presemce of RH+ fetal blood in maternal circulation
|
|
|
What are some causes of 2nd trimester bleeding?
|
- placenta previa
- placental abruption - preterm labor - previability: cervical incompetence - recent coitus - cervical polyps, cancer |
|
|
What are different grades of placenta previa?
|
- low lying placenta
- marginal placenta previa - partial placenta previa - complete placenta previa |
|
|
Risk factors for placenta previa.
|
- prior c-sections and uterine surgeries
- multiparity - multiple gestation - smoking - h/o placenta previa - increased maternal age |
|
|
What is this?
- "sentinel bleed" after 28wk gestation - sudden profuse painless vaginal bleeding |
placenta previa
|
|
|
How to diagnose placenta previa?
|
- u/s: transabdominal, translabial
- vaginal exam and u/s contraindicated |
|
|
How to manage placenta previa?
|
- strict bed rest
- c section if unstoppable labor, fetal distress, or life threatening bleed |
|
|
How to manage this case?
- placenta previa with accreta |
- hysterectomy at the time of delivery (puerperal hysterectomy)
|
|
|
Definitions of these terms:
- placenta accreta - placenta increta - placenta percreta - vasa previa |
- placenta accreta: placenta invades superficial uterine wall
- placenta increta: placenta invades myometrium - placenta percreta: placenta invades uterine serosa - vasa previa: fetal vessels course over cervix |
|
|
What are some complications of placenta previa?
|
- hemorrhage
- preterm delivery - PPROM - IUGR - comgenital malformation - risk pf puerperal hysterectomy |
|
|
How to diagnose placenta accreta?
|
- MRI is the best imaging choice
|
|
|
How to manage placenta accreta?
|
- surgical planning
- catheter placement, pre-op for embolization if necessary - expect to transfuse |
|
|
What is placental abruption?
|
- premature separation of normally implanted placenta from the uterine wall resulting in hemorrhage between uterine wall and placenta
|
