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26 Cards in this Set
- Front
- Back
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Separation of the placenta from the deciduas basalis before delivery of the fetus
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placental abruption
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What are the primary risk factors of placental abruption
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-HTN
-Multiparity -tobacco use -cocaine use -trauma -hx of previous abruption -advanced age |
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What is a concern in regard to the bleeding caused by placental abruption?
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the bleeding may be retroplacental - which would conceal the blood loss
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What is the classic clinical presentation of placental abruption
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painful vaginal bleeding with uterine contractions and ternderness
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What are the maternal complications of placental abruption
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-hemorrhagic shock, ARF, Coagulopathy
*also, most common cause of DIC in pregnancy |
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What is the most common cause of DIC in pregnancy
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placental abruption
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What are the fetal complications of placental abruption
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-Fetal demise
-hypoxia -IUGR -premature delivery *most common cause of intrpartum fetal death |
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What is the most common cause of intrapartum fetal death
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placental abruption
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Uterine wall defect that threatens health of fetus and/or mother
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uterine rupture
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What are the primary risk factors for uterine rupture
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1. scarred uterus
2. intrauterine manipulation 3. multiparity |
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What is the clinical presentation of uterine rupture
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Continuous abdominal pain and hypotension (with non-reassuring or loss of FHR tracing)
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what is the best means of detecting uterine rupture
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Continuous electronic FHR monitoring
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What is the treatment of uterine rupture?
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STAT GETA
-clamp hypogastric or internal iliac arteries -laparotomy and hysterectomy required! |
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T or F
uterine rupture may also occur postpartum |
True
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What is the incidence of PPH
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5% of all deliveries
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This type of PPH occurs within the 1st 24 hours after delivery
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Primary PPH
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This type of PPH occurs between 24 hrs and 6 wks after delivery
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secondary PPH
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What are the chief causes of PPH?
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-uterine atony
-retained placenta - uterine inversion - placenta accreta -genital trauma |
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What is the most common cause of severe PPH - and is defined as a lack of effective PP uterine contractions
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Uterine Atony
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the following describes the clinical presentation of which OB condition:
"soft" uterus with substantial ongoing blood loss |
uterine atony
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What is the treatment of uterine atony
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1. uterine/fundal massage
2. pitocin, methergine, hemabate, cytotec |
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What is the plan of action if uterine atony is not controlled by massage and admin of uterotonics?
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* emergency surgery
-embolization -ligation of arteries -hysterectomy |
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This condition occurs in approx 3% of deliveries and is defined as "placenta or placental fragment retention w/in the uterus for an abnormal duration of time after delivery of the neonate"
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retained placenta
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T or F
with retained placenta, the uterus is unable to contract efficiently ( hypotonic /hypertonic contractions) |
True
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What is the treatment of Retained placenta
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manual removal of placenta (under anesthesia)
-extending epidural block -IV sedation NGT IV 50-100 mcg |
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Why do we administer uterotonic agents immediately following the delivery of a retained placenta
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pt is at risk for uterine inversion
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