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49 Cards in this Set

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defin spon abortion
*under what wk*
nonelective termination of preg <20 wks gestational age
*over what wk* is third trimester bleeding
after 20 wks
T or F: SAB is
common cz of 1st tri bleeding
T
2 common cz of 3rd tri bleeding
placental abruption
placenta previa
1st tri SAB caused by
maternal or fetal factors,
& example
*fetal (chromosomal abn)*
2nd tri SAB caused by
maternal or fetal factors,
& examples
maternal
(cervical incompetence, infection,
hypercoagable state)
Premature Rupture of Memb (PROM) (spon ROM b/4 onset of labor) may be precip by? rf?
cervical incompt
infection-vag/cervical
abn memb physiology
RF: low socioeco, young, smoke, STD
Preterm labor is b/w 20-37 wks, RF are?
infection
mult gestation/polyhydramnios
PROM
uterine abn
hx preterm labor
placental abruption
poor maternal nutrition
low socioeconomic status
*most pts no ident RF*
RF for spon abortion
AMA, APA
inc gravidity
minority
hx prior SAB
On hx, ask:
familial genetic abn (most common cz of 1st tri bl)
infection (2nd tri bl)
hx of abortions
Pt w/ vaginal bl, what to look for in pelvic exam?
1. vag bl
2. passage of tissue
3. open or closed cervical os
7 types of SAB
1. threatened ab
2. inevitable ab
3. incomplete ab
4. complete ab
5. missed ab
6. septic ab
7. intrauterine fetal demise
threatened ab sx
*min bl, no POC expelled*
pos abd pain
amt bl, poc expel?
threatened ab PE (os)/us
closed internal cervical os
normal us
os: open or close
threatened ab tx
avoid heavy activity;
pelvic and bed rest
restriction on activity
inevitable ab sx
*profuse bl, sev cramp*
amt bl
inevitable ab pe (os)
open internal cervical os
os: open or close
inevitable ab tx
emergent d/c
incomplete ab sx
somc poc expel
incomplete ab pe(os)/us
open internal cervical os
retained fetal tissue on us
os: open or closed
incomplete ab tx
emergent d/c
complete ab sx
min bl/cramp
*all poc expel*
complete ab pe(os)/us
closed internal cervical os
empty uterus on u/s
missed ab sx
no uterine bl
*no poc expel*
missed ab pe(os)/us/fetal heart monitor
os closed
us: retained fetal tissue
no fetal cardiac activity
missed ab tx
evacuate uterus
d/c
septic ab sx
f/c
peritoneal signs
recent hx of therapeutic ab
(maternal mortality 10-50%)
septic ab pe
sx of shock: hypotension,
hypothermia, oliguria, resp distress
inc WBC
septic ab tx
evac uterus
d/c
IV abx
intrauterine fetal demise sx
mom report absence of fetal movement
interuterine fetal demise pe/fetal heart monitor/us
uterus sm for GA
no fetal heart tones or movement on us
intrauterine fetal demise tx
induce labor and evac uterus to avoid d/c
os open or closed on
threatened, inevitable, incomplete, complete, missed
open: inevitable, incomplete
closed: threatened, complete, missed
which SAB no POC expel
threatened, missed
which SAB all POC expel
complete
which SAB some POC expel
incomplete
which SAB w/ no bl, min bl, sev bl
no bl: missed
min bl: threatened, complete
sev bl: inevitable
which SAB has normal us
threatened
which SAB has no fetal cardiac activity
missed ab, intrauterine fetal demise
DDx of SAB
post-coital bl (not preg)
vaginal or cervical lesions
ectopic preg
extrusion of molar preg
if not preg, if "preg"
T or F
if signif bl in SAB (which one is sev), must ensure hemodynamic stability
T
inevitable ab
after hemodyn stable, what test to check preg
beta-hCG
what labs to eval bl loss and Rh immunization
CBC
bl type
antibody screen
what tool to assess fetal viability
transvaginal us
T or F
after hemodyn stable and estab preg, estab GA if threatened ab OR check remaining tissue if incomplete, complete
T
what shot give after Rh neg woman has SAB
RhoGAM
Mech of RhoGAM
anti-RhIgG destroys Rh-positive cells in maternal circulation and prevents Rh sensitization
3 situations in prevention of Rh negative moms
1. father Rh pos
2. father Rh status unknown
3. paternity uncertain
typical management of SAB (usu in missed, septic)
*evacuate uterus*
prev infection