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49 Cards in this Set

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  • Back
  • 3rd side (hint)
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
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
(cervical incompetence, infection,
hypercoagable state)
Premature Rupture of Memb (PROM) (spon ROM b/4 onset of labor) may be precip by? rf?
cervical incompt
abn memb physiology
RF: low socioeco, young, smoke, STD
Preterm labor is b/w 20-37 wks, RF are?
mult gestation/polyhydramnios
uterine abn
hx preterm labor
placental abruption
poor maternal nutrition
low socioeconomic status
*most pts no ident RF*
RF for spon abortion
inc gravidity
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
septic ab sx
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
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
which SAB some POC expel
which SAB w/ no bl, min bl, sev bl
no bl: missed
min bl: threatened, complete
sev bl: inevitable
which SAB has normal us
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
inevitable ab
after hemodyn stable, what test to check preg
what labs to eval bl loss and Rh immunization
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
what shot give after Rh neg woman has SAB
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