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;
14 Cards in this Set
- Front
- Back
|
In the general initial assessment, do NOT do a digital exam until _________ has been ruled out!!
|
placenta previa (low lying placenta at cervical os)
|
|
|
What are some risk factors for placenta previa?
|
Anything that can scar the uterus, including:
- multiparous patients - previous D&C - previous C-section - myomectomy - multiple gestation - advanced maternal age - smoking |
|
|
True or False:
If on ultrasound you assess the placenta as complete previa, then vaginal delivery is NOT recommended. |
TRUE
|
|
|
[ Placenta previa / Placental abruption ] is characterized by painless third trimester vaginal bleeding with a soft, nontender abdomen.
|
Placenta previa
Hospitalize at first bleed if about 24 weeks along and have woman stay in antepartum suite for ~ 1 week. Upon second bleed, however far along, admit to hospital. Third bleed, deliver baby. |
|
|
What is the condition called when....
A. the placenta grows THROUGH the uterine wall B. the placenta attaches directly to the surface of the myometrium (no intervening decidual cells) C. the placenta invades partway into the myometrium |
A. the placenta grows THROUGH the uterine wall : PERCRETA
B. the placenta attaches directly to the surface of the myometrium (no intervening decidual cells): ACCRETA C. the placenta invades partway into the myometrium: INCRETA |
|
|
What are risk factors for placental abruption?
|
Abruption, or abnormal separation of normally implanted placenta, is possible if the mother has the following risk factors: older age, HTN, PPROM, uses tobacco, fetus has polyhdramnios, thrombophillias, mom has had prior abruption, uterin trauma (as in MVA).
|
|
|
True or False:
All placental abruption presents with painful vaginal bleeding. |
FALSE. Only 80% of presentations bleed, 20% don't! But if they were to, yes it would be painful vaginal bleeding with a hard, painful uterus.
|
|
|
How does one diagnose abruption? How do you treat it?
|
Ultrasound! And, fetal heart decelerations. Treat abruption by prompt delivery if fetus is viable. By vaginal delivery if IUFD.
|
|
|
What is vasa previa condition?
|
Velamentous insertion of the umbilical cord. Vessels run over cervical os! The mothers/babies are more prone to artificial rupture of membranes. Bright red vaginal bleeding occurs, acute fetal heart rate decels occur. There is upto 50% fetal mortality!! Thus, start c-section right away!
|
|
|
What OB condition causes "ascent of presenting part"?
|
UTERINE RUPTURE! Nothing else does this!! Patient could also have a tearing sensation or feel a hot spot when this occurs. Vaginal bleeding, hypotension and fetal bradycardia quickly ensue.
|
|
|
What is the most typical presentation of cervical tumors?
|
Post-coital bleeing
|
|
|
When a mother is experiencing post partum hemorhage, worry about...
|
lacerations, retaind POC, uterine atony, amniotic fluid embolus
|
|
|
Feeling of impending doom, acute respiratory distress, cardiovascular collapse can occur any time during pregnancy but typically occurs (if it does) after delivery. What condition is this?
A. lacerations causing post partum hemorrhage B. retained products causing post partum hemorrhage C. uterine atony causing post partum hemorrhage D. amniotic fluid embolus |
D. amniotic fluid embolus
|
|
|
What are appropriate treatment for post artum hemorrhage due to uterine atony? (physical, meds, surgery)
|
physical: bimanual massage
meds: pitocin, methergine, prostaglandins, misoprostil surgery: hysterectomy |
