Hysteroscopy for Uterine Rupture Repair
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Questions and Answers

What is a potential consequence of nicotine use during pregnancy related to abruptio placenta?

  • Enhanced oxygenation in the placenta
  • Development of micro infarctions in the placenta (correct)
  • Reduced carboxyhemoglobin levels
  • Increased uterine contractions
  • In the classification of abruptio placenta proposed by Smith in 2019, which classification indicates that the diagnosis is made retrospectively?

  • Class III
  • Class II
  • Class 0 (correct)
  • Class I
  • Which symptom is commonly associated with abruptio placenta?

  • Normal uterine tenderness
  • Sudden onset of abdominal pain (correct)
  • Gradual abdominal pain
  • Diminished uterine contractions
  • What mechanism does cocaine use potentially disrupt during pregnancy related to abruptio placenta?

    <p>Leads to vasoconstriction of uterine and umbilical arteries</p> Signup and view all the answers

    Which finding is NOT associated with the severity classifications of abruptio placenta?

    <p>Presence of myoma</p> Signup and view all the answers

    Which of the following findings suggests that uterine contractions are not in a normal state?

    <p>Contractions are tetanic and very strong</p> Signup and view all the answers

    What is one of the effects of elevated carboxyhemoglobin concentrations during pregnancy?

    <p>Impeded oxygenation of fetal tissues</p> Signup and view all the answers

    Which of the following is a common sign of abruptio placenta that occurs during the late stage of labor?

    <p>Significant uterine tenderness</p> Signup and view all the answers

    What is a potential consequence of including myometrium during the resection of an endometrial polyp?

    <p>It increases the risk of uterine rupture.</p> Signup and view all the answers

    In what method is hysteroscopy primarily performed?

    <p>Transvaginally</p> Signup and view all the answers

    What characteristic indicates a higher risk of repeat rupture after a previous C-section?

    <p>Repair of uterine dehiscence.</p> Signup and view all the answers

    Which type of ectopic pregnancy occurs at the ampulla?

    <p>Ampulla Ectopic Pregnancy</p> Signup and view all the answers

    What is a noted complication of abortion with curettage beyond the myometrium?

    <p>Formation of scar tissue.</p> Signup and view all the answers

    What is the purpose of deep cornual resection in interstitial ectopic pregnancy?

    <p>To remove the ectopic tissue while preserving the uterus.</p> Signup and view all the answers

    What is the most significant characteristic of placenta previa?

    <p>It often presents with painless vaginal bleeding.</p> Signup and view all the answers

    Which statement is true about the timing of uterine ruptures in relation to previous surgical events?

    <p>They typically occur 1-2 weeks after the previous event.</p> Signup and view all the answers

    What anatomical location does the placenta previa often affect?

    <p>The internal os of the cervix.</p> Signup and view all the answers

    What type of trauma is specifically mentioned as a cause of incidental injury in the given context?

    <p>Vehicular trauma</p> Signup and view all the answers

    How does bleeding associated with placenta previa typically occur?

    <p>Without any prior warning and without contractions.</p> Signup and view all the answers

    What is a critical risk factor to consider in any case of vaginal bleeding after mid-pregnancy?

    <p>Placenta previa.</p> Signup and view all the answers

    What diagnostic action is contraindicated in the case of suspected placenta previa?

    <p>Digital vaginal examination.</p> Signup and view all the answers

    What does the term 'previa' signify in the context of placenta previa?

    <p>Going before or in front of.</p> Signup and view all the answers

    During which trimester does placenta previa typically manifest?

    <p>Late in the second trimester or later.</p> Signup and view all the answers

    What can cause bleeding in cases of placenta previa?

    <p>Dilation of the internal os.</p> Signup and view all the answers

    What is the primary purpose of a transabdominal scan in the context of placental localization?

    <p>To request information for placenta localization</p> Signup and view all the answers

    What is the gold standard for assessing placental localization?

    <p>Transabdominal scan</p> Signup and view all the answers

    What is meant by placental migration?

    <p>The growth of the placenta towards the fundus without obstruction</p> Signup and view all the answers

    What does trophotropism refer to in placental development?

    <p>The growth of placenta towards the fundus due to adequate blood supply</p> Signup and view all the answers

    When must the uterus develop a lower uterine segment for labeling placenta previa?

    <p>By 28 weeks of gestation</p> Signup and view all the answers

    What commonly contributes to advanced maternal age as a risk factor for placental development issues?

    <p>Changes in hormonal or implantation environment</p> Signup and view all the answers

    Which factor is indicated as a contributing risk for having multiple uterine procedures?

    <p>Multiparity</p> Signup and view all the answers

    What occurs to the placental edge when assessed at 35 weeks if placental migration has occurred?

    <p>Absence of encroachment on the internal os</p> Signup and view all the answers

    What is the most likely diagnosis when hemorrhages are seen along the serosal areas following a cesarean section?

    <p>Abruptio Placenta</p> Signup and view all the answers

    What symptom is most indicative of abruptio placenta in a term patient with labor pains?

    <p>Bloody amniotic fluid</p> Signup and view all the answers

    Which of the following conditions does NOT typically present with acute fetal bradycardia?

    <p>Placenta Previa</p> Signup and view all the answers

    In a patient exhibiting gradual depression of fetal heart tones, which condition is most likely?

    <p>Uterine Rupture</p> Signup and view all the answers

    What is considered a key feature in diagnosing vasa previa during labor?

    <p>Presence of fetal vessels over the cervix</p> Signup and view all the answers

    What is a primary risk associated with placenta previa during delivery?

    <p>High risk for hemorrhage</p> Signup and view all the answers

    Which condition is NOT associated with severe fetal bradycardia?

    <p>Placenta Previa</p> Signup and view all the answers

    Which finding would suggest a diagnosis of uterine rupture over other conditions?

    <p>Development of severe maternal hypotension</p> Signup and view all the answers

    Study Notes

    C-Section Complications and Surgical Interventions

    • Hysteroscopy allows visualization of the inner uterine cavity and can repair previous uterine ruptures.
    • Uterine dehiscence after a C-section increases the risk of repeat ruptures during future pregnancies.
    • Hysteroscopic resection may unintentionally create myometrial weakness.
    • Complications from prior C-sections may manifest 1-2 weeks earlier than the previous event.

    Ectopic Pregnancy

    • Types include ampullary and cervical ectopic pregnancies.
    • Deep cornual resection addresses interstitial ectopic pregnancies.

    Abruptio Placenta

    • Hypoxia-related factors can influence abruptio placenta, including maternal nicotine and cocaine use.
    • Abruptio placenta can cause micro-infarctions in the placenta, leading to thrombus formation.
    • In 2019, classifications of abruptio placenta based on severity were proposed, highlighting medical understanding.

    Clinical Features of Placenta Previa

    • Characterized by painless vaginal bleeding that may occur without uterine contractions.
    • Can lead to significant bleeding, particularly if the placenta covers the internal os.
    • Often diagnosed using transabdominal and transvaginal scans to locate the placenta.

    Pathology and Diagnosis of Placenta Previa

    • Defined as premature separation of an abnormally positioned placenta.
    • Diagnosis follows any mid-pregnancy vaginal bleeding; digital examinations are contraindicated.

    Placental Migration and Risk Factors

    • Typical placental growth trends towards the fundus; misnomers around "placental migration" exist.
    • Risk factors for placenta previa include advanced maternal age, higher parity, and history of uterine surgeries.

    Imaging and Observation

    • Close monitoring of high-risk pregnancies is crucial, particularly for patients with placenta previa.
    • Early admission is recommended to manage potential hemorrhage risks.

    Case Studies and Differential Diagnosis

    • Abruptio placenta display hemorrhages along the serosal areas during operative findings.
    • Key clinical signs for abruptio placenta include sudden abdominal pain and unusual fetal heart monitoring results.
    • Accurate diagnosis is critical in differentiating between conditions like uterine rupture and placenta previa, based on clinical presentation and examination findings.

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    Description

    This quiz covers the procedure and implications of performing hysteroscopy on a patient with a previous C-section and uterine rupture. Learners will explore the importance of visualizing the inner uterine cavity and the associated risks and techniques for repair.

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