Podcast
Questions and Answers
What is the primary diagnostic method for identifying an irritable uterus after excluding other conditions?
What is the primary diagnostic method for identifying an irritable uterus after excluding other conditions?
Clinical diagnosis is made after ruling out placenta previa and local causes.
What role does ultrasound play in the evaluation of an irritable uterus?
What role does ultrasound play in the evaluation of an irritable uterus?
Ultrasound is used to confirm fetal size, fetal lie, and to rule out placenta previa.
What are the initial management steps for a mother with an irritable uterus and suspected fetal distress?
What are the initial management steps for a mother with an irritable uterus and suspected fetal distress?
Early delivery is vital, and the mother must be stabilized with an IV line and necessary blood tests.
What complications can arise from an irritable uterus and what percentage of patients might experience coagulopathy?
What complications can arise from an irritable uterus and what percentage of patients might experience coagulopathy?
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What is a Couvelaire uterus, and what causes it?
What is a Couvelaire uterus, and what causes it?
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Flashcards
Couvelaire Uterus
Couvelaire Uterus
Life-threatening condition where placental separation causes bleeding into the uterine muscle and peritoneum.
Placental Abruption
Placental Abruption
Premature separation of the placenta from the uterus.
Diagnosis of Irritable Uterus
Diagnosis of Irritable Uterus
Diagnosis of irritable uterus is clinical, excluding other causes, and confirmed by a retro-placental clot after delivery.
Management Prioritizes
Management Prioritizes
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Couvelaire Uterus Complications
Couvelaire Uterus Complications
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Study Notes
Irritable Uterus
- Diagnosis is clinical, excluding previa and local causes.
- Confirmed by demonstrating a retro-placental clot indenting the placental substance post-delivery.
- Ultrasound role is to confirm fetal size, lie, and rule out placenta praevia.
- Ultrasound may detect a large retro-placental clot.
- Intrauterine death indicates at least 2L maternal blood loss.
Management
- Prompt delivery is critical, stabilizing the mother.
- Intravenous line, complete blood count, blood grouping and cross-matching of 4 units, and coagulation screening are essential.
- Continuous cardiotocography monitoring.
- Emergency cesarean section if the baby is alive and gestation is not too premature.
- Vaginal delivery with amniotomy if the fetus is already deceased.
Complications
- Coagulopathy (30% incidence) due to low fibrinogen, platelets, and high fibrin degradation products.
- Disseminated intravascular coagulation due to thromboplastins from the damaged placenta.
- Hypovolemia can lead to multisystem organ failure.
- Expert hematological consultation is recommended.
- Increased risk of postpartum hemorrhage and hemorrhage during cesarean section if coagulopathy present.
Couvelaire Uterus
- Life-threatening condition.
- Placenta abruption causes bleeding into uterine myometrium and peritoneum.
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Description
This quiz focuses on the clinical diagnosis and management strategies for an irritable uterus. It covers the role of ultrasound in confirming conditions, the importance of timely delivery, and potential complications. Test your knowledge on this critical obstetric condition.
