N113 - Placental/Bleeding problems
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| Placenta previa | show 🗑
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| show | Does not cover the cervical opening
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| show | Partially covers the cervical opening
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| Complete placenta previa | show 🗑
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| Placenta previa cautions | show 🗑
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| show | Depends on type of previa, condition of mother & fetus, amount of bleeding, # of weeks gestation
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| show | Emergency situation,usually painful. Premature separation of placenta, can cause hemorrhage
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| Complete abruptio | show 🗑
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| show | Painful, sudden bleeding. S/S of shock - increased BP, decreased pulse. Hard uterus, if bleeding is concealed.
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| show | Maternal - death, but uncommon, DIC, renal failure
Fetal death from lack of O2.
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| show | C-section, hydration, transfusion may be necessary, hysterectomy may be needed.
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| Couvelaire uterus | show 🗑
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| show | Molar pregnancy - Chorionic villi of placenta become edematous & fluid-filled grape like clusters.
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| Ruptured uterus | show 🗑
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| show | Through the 3 muscular layers
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| Incomplete rupture | show 🗑
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| Rupture cause | show 🗑
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| show | HEMORRHAGE - resulting in shock
Infection - peritonitis - complication
PAIN
Change in fetal station - fetus rising up in the abdomen, change in abdominal contour, abrupt stop of contractions, fetal distress
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| show | With complete rupture, fetus is forced into abdomen and can die quickly - depends on where the placenta location & where rupture occurs
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| Rupture treatment | show 🗑
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| Rh Factor | show 🗑
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| show | Indirect Coombs test - done on maternal blood, measures antibodies
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| show | Done on infant after birth from cord blood
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| show | Given 72 postpartum to prevent sensitization. Also given after amniocentesis, abortion and routinely during prenatal care at 28 & 34 weeks to Rh negative women - preventative measure.
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| Abortion | show 🗑
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| show | If embryo dies, this leads to drop in hcG and progesterone during 1st trimester.
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| show | Unexplained bleeding, cramping & backache. Cervix is closed, partial or complete expulsion may occur
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| Imminent abortion | show 🗑
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| Incomplete abortion | show 🗑
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| Missed abortion | show 🗑
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| Habitual abortion | show 🗑
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| Treatment during impending loss | show 🗑
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| show | Cramping usually present if abortion
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| show | Implantation of blastocyst in site other than uterus
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| show | Fallopian tube, ovary, peritoneal cavity, cervix, uterine cornua
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| Ectopic symptoms | show 🗑
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| show | Sharp, one sided pain, may radiate. Syncope, referred shoulder pain, internal hemorrhage from ruptured tube.
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| Ectopic treatment | show 🗑
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