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Questions and Answers
Questions and Answers
What does the term "vasa previa" mean when translated from Latin?
What does the term "vasa previa" mean when translated from Latin?
- Vessels are located after the fetus in the birth canal
- Vessels are located behind the fetus in the birth canal
- Vessels are located before the fetus in the birth canal (correct)
- Vessels are located next to the fetus in the birth canal
What is the approximate occurrence rate of vasa previa in pregnancies?
What is the approximate occurrence rate of vasa previa in pregnancies?
- 1 in 1000 pregnancies (correct)
- 1 in 10 pregnancies
- 1 in 10,000 pregnancies
- 1 in 100 pregnancies
What is the defining characteristic of Type 1 Vasa Previa?
What is the defining characteristic of Type 1 Vasa Previa?
- Blood vessels cross the internal cervical os unprotected
- Blood vessels originate from the succenturiate lobe of the placenta
- Blood vessels travel from the velamentous insertion (membranes of the placenta) (correct)
- Blood vessels originate from the additional lobe of the placenta
Where are the blood vessels located in Type 1 Vasa Previa?
Where are the blood vessels located in Type 1 Vasa Previa?
What is the primary risk associated with Type 1 Vasa Previa?
What is the primary risk associated with Type 1 Vasa Previa?
How is Type 2 Vasa Previa typically diagnosed?
How is Type 2 Vasa Previa typically diagnosed?
What is the primary difference between vasa previa and placenta previa?
What is the primary difference between vasa previa and placenta previa?
Which of the following symptoms is a maternal indication of potential preeclampsia?
Which of the following symptoms is a maternal indication of potential preeclampsia?
What test is specifically used to monitor fetal heart rate and movement?
What test is specifically used to monitor fetal heart rate and movement?
Which management approach can be utilized for maternal hypertension if necessary?
Which management approach can be utilized for maternal hypertension if necessary?
What is a potential consequence of untreated retained placenta?
What is a potential consequence of untreated retained placenta?
What is an effective strategy for reducing complications related to placental insufficiency?
What is an effective strategy for reducing complications related to placental insufficiency?
Which condition is NOT considered a cause of a retained placenta?
Which condition is NOT considered a cause of a retained placenta?
What is generally true about the prevention of placental insufficiency?
What is generally true about the prevention of placental insufficiency?
Which of the following statements regarding retained placenta is accurate?
Which of the following statements regarding retained placenta is accurate?
What condition occurs when the placenta is implanted in the lower part of the uterus, potentially covering the cervix?
What condition occurs when the placenta is implanted in the lower part of the uterus, potentially covering the cervix?
Which complication is indicated by unprotected blood vessels from the umbilical cord that travel across the cervical opening?
Which complication is indicated by unprotected blood vessels from the umbilical cord that travel across the cervical opening?
What type of placental condition involves the placenta being more deeply embedded in the uterine wall?
What type of placental condition involves the placenta being more deeply embedded in the uterine wall?
Which term describes the condition where the placenta extends through the uterine wall and possibly into other organs?
Which term describes the condition where the placenta extends through the uterine wall and possibly into other organs?
Which complication involves the placenta not providing enough nutrients and oxygen to the fetus?
Which complication involves the placenta not providing enough nutrients and oxygen to the fetus?
What is the condition where some of the placenta remains in the uterus after the baby is born?
What is the condition where some of the placenta remains in the uterus after the baby is born?
What condition describes the premature separation of the placenta from the uterine wall before delivery?
What condition describes the premature separation of the placenta from the uterine wall before delivery?
Which diagnostic procedure provides clearer images of placental invasion when ultrasound findings are inconclusive?
Which diagnostic procedure provides clearer images of placental invasion when ultrasound findings are inconclusive?
What is the primary imaging method used for diagnosing placenta accreta, increta, and percreta during pregnancy?
What is the primary imaging method used for diagnosing placenta accreta, increta, and percreta during pregnancy?
Which of the following imaging techniques is particularly useful for evaluating blood flow and identifying abnormal vascularity in the placenta?
Which of the following imaging techniques is particularly useful for evaluating blood flow and identifying abnormal vascularity in the placenta?
What role does MRI play in the diagnosis of placenta accreta, increta, and percreta?
What role does MRI play in the diagnosis of placenta accreta, increta, and percreta?
Which clinical signs might indicate a suspicion of placenta accreta?
Which clinical signs might indicate a suspicion of placenta accreta?
What is the primary goal of managing conditions such as placenta accreta, increta, or percreta?
What is the primary goal of managing conditions such as placenta accreta, increta, or percreta?
Which of the following is a common medication given to prevent infection during the treatment of placenta accreta?
Which of the following is a common medication given to prevent infection during the treatment of placenta accreta?
What factor should raise suspicion for placenta accreta and prompt closer monitoring?
What factor should raise suspicion for placenta accreta and prompt closer monitoring?
In which trimester is placenta accreta most commonly diagnosed using imaging methods?
In which trimester is placenta accreta most commonly diagnosed using imaging methods?
Which of the following factors can contribute to difficulty in uterine contractions?
Which of the following factors can contribute to difficulty in uterine contractions?
What is the maximum time frame for placenta expulsion after delivery to avoid being classified as retained placenta?
What is the maximum time frame for placenta expulsion after delivery to avoid being classified as retained placenta?
Which treatment option is NOT typically used for retained placenta?
Which treatment option is NOT typically used for retained placenta?
What symptom might indicate that the retained placenta has led to an infection?
What symptom might indicate that the retained placenta has led to an infection?
Which of the following treatments can be used to promote uterine contractions after delivery?
Which of the following treatments can be used to promote uterine contractions after delivery?
What might be a consequence of a long labor on the uterus regarding placenta retention?
What might be a consequence of a long labor on the uterus regarding placenta retention?
Which medication is an example of a uterotonic that may be used for retained placenta?
Which medication is an example of a uterotonic that may be used for retained placenta?
What should be done immediately if severe hemorrhage occurs due to retained placenta?
What should be done immediately if severe hemorrhage occurs due to retained placenta?
What is the main purpose of non-stress tests during pregnancy?
What is the main purpose of non-stress tests during pregnancy?
How often might a provider schedule non-stress tests for a pregnant person?
How often might a provider schedule non-stress tests for a pregnant person?
What is the recommended delivery method for a pregnancy complicated by vasa previa?
What is the recommended delivery method for a pregnancy complicated by vasa previa?
What role do corticosteroids play in managing pregnancies with potential complications?
What role do corticosteroids play in managing pregnancies with potential complications?
What is placental insufficiency?
What is placental insufficiency?
Which of the following actions can help improve outcomes for vasa previa?
Which of the following actions can help improve outcomes for vasa previa?
What factor significantly affects the decision to recommend inpatient management before delivery?
What factor significantly affects the decision to recommend inpatient management before delivery?
What is a possible consequence of untreated placental insufficiency for the fetus?
What is a possible consequence of untreated placental insufficiency for the fetus?
Questions and Answers
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Flashcards
Flashcards
Placental Insufficiency
Placental Insufficiency
A condition during pregnancy where the placenta doesn't supply enough oxygen and nutrients to the baby.
Retained Placenta
Retained Placenta
The placenta doesn't fully detach from the uterus after birth.
Fetal Growth Restriction (FGR)
Fetal Growth Restriction (FGR)
Reduced blood flow to the baby. It's a major concern in placental insufficiency.
Preeclampsia
Preeclampsia
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Non-Stress Test (NST)
Non-Stress Test (NST)
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Biophysical Profile (BPP)
Biophysical Profile (BPP)
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Uterine Atony
Uterine Atony
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Placenta Accreta
Placenta Accreta
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Placenta Percreta
Placenta Percreta
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Ultrasound in Placenta Accreta
Ultrasound in Placenta Accreta
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MRI in Placenta Accreta
MRI in Placenta Accreta
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Multidisciplinary Team for Accreta
Multidisciplinary Team for Accreta
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What is vasa previa?
What is vasa previa?
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Prophylactic Antibiotics for Accreta
Prophylactic Antibiotics for Accreta
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Describe type 1 vasa previa.
Describe type 1 vasa previa.
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Describe type 2 vasa previa.
Describe type 2 vasa previa.
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Delivery Planning for Accreta
Delivery Planning for Accreta
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What is the risk associated with vasa previa?
What is the risk associated with vasa previa?
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What is placenta previa?
What is placenta previa?
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How does vasa previa differ from placenta previa?
How does vasa previa differ from placenta previa?
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How is vasa previa diagnosed?
How is vasa previa diagnosed?
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How are vasa previa and placenta previa diagnosed?
How are vasa previa and placenta previa diagnosed?
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Postpartum Hemorrhage
Postpartum Hemorrhage
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Failure of Placental Expulsion
Failure of Placental Expulsion
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Uterotonics
Uterotonics
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Manual Removal
Manual Removal
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Surgical Removal
Surgical Removal
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Abdominal Massage
Abdominal Massage
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Breastfeeding
Breastfeeding
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Vasa Previa
Vasa Previa
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Non-stress Test
Non-stress Test
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Corticosteroids
Corticosteroids
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Inpatient Management
Inpatient Management
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Scheduled C-section (Weeks 34 to 37)
Scheduled C-section (Weeks 34 to 37)
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Neonatal Intensive Care Unit (NICU)
Neonatal Intensive Care Unit (NICU)
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Cesarean Section (C-section)
Cesarean Section (C-section)
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Placenta Previa
Placenta Previa
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Abruptio Placenta
Abruptio Placenta
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Flashcards
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Study Notes
Study Notes
Placenta Complications in Pregnancy
- The placenta is a vital organ developing during pregnancy, acting as a life support for the fetus.
- Placenta functions include nutrient and oxygen transfer from mother to fetus, waste removal from fetus to mother, hormone production (e.g., HCG, progesterone), and immunological protection against infections.
- Placental complications pose significant risks to both the mother and the fetus.
Placental Abruption
- Placental abruption is the premature separation of the placenta from the uterine wall before delivery.
- It commonly occurs around 25 weeks of pregnancy.
- Types of placental abruption include:
- Partial: Placenta separates in a small area; mild cases may involve monitoring and activity restrictions.
- Complete: Placenta separates completely from the uterine wall, usually resulting in significant bleeding requiring immediate delivery.
- Revealed: Moderate to severe visible vaginal bleeding.
- Concealed: Little or no visible vaginal bleeding, with blood trapped between the placenta and uterine wall.
- Severity can be classified into grades (1-3) based on the percentage of detached placenta. Higher grades have more severe symptoms.
Risk Factors for Placental Abruption
- Smoking
- Early membrane rupture during pregnancy
- Placental abruption in prior pregnancies or family history of placental abruption
- Uterine infections during pregnancy
- Cocaine use during pregnancy
- Mother has asthma
- Maternal age of 35 or older
- Carrying multiple babies
- Hypertension or related pregnancy problems (e.g., preeclampsia, eclampsia)
- Maternal exposure to air pollution
- A fall or blow to the abdomen during pregnancy
- Water breaks before 37 weeks
Symptoms of Placental Abruption
- Sudden lower abdominal pain
- Problems with the baby's heart rate
- Vaginal bleeding
- Tense, rigid uterus
- Fetal distress (e.g., decreased fetal movement)
- Dangerously low blood pressure
Diagnosis of Placental Abruption
- Physical exam: Checks for uterine tenderness/rigidity.
- Ultrasound: Uses high-frequency sound waves to image the uterus and locate bleeding. Not always conclusive.
- Blood and urine tests: May include CBC, blood/Rh typing, PT/PTT, fibrinogen, and fibrin-split products.
- Fetal monitoring: Monitors fetal heart rate and movement.
Management of Placental Abruption
- Initial Assessment: Vital signs (BP, heart rate, respiratory rate), fetal heart rate monitoring, physical exam for uterine abnormalities, and estimation of blood loss.
- Stabilization: IV fluids and possible blood transfusions, oxygen therapy, and blood tests (hemoglobin, hematocrit, coagulation profile, and organ function).
- Delivery Consideration: If fetal distress or the pregnancy is term - Cesarean section is the preferred method. Stable mother/fetus - Longer hospital observation.
- Postpartum Care: Monitor for hemorrhage, uterine tone, signs of shock, and close maternal monitoring in the immediate postpartum period.
Placenta Previa
- Placenta previa: Placenta attaches inside the uterus near or over the cervical opening.
- Symptoms: Vaginal bleeding in the second half of pregnancy; bright red, usually painless.
- Types of Placenta Previa:
- Complete: Placenta completely covers the cervical opening.
- Partial: Placenta covers part of the cervical opening.
- Marginal: Placenta is near the cervical opening but does not cover it.
- Low-lying: Placenta is low in the uterus but does not cover the cervical opening.
- Causes/Risk Factors: Twin or multiple pregnancies, prior pregnancies, short time between births, prior cesarean sections, uterine scars from prior abortions or surgeries, advanced maternal age, and tobacco/cocaine use.
- Diagnosis: Ultrasound to check the location of placenta.
- Symptoms: Painless vaginal bleeding, usually bright red, occurring in the second half of pregnancy.
- Management: Close monitoring, possible hospitalisation according to the type and severity. Cesarean section delivery is preferred; vaginal delivery may be possible if the condition is diagnosed early and the placenta is low-lying.
Placenta Accreta, Increta, and Percreta (PAS)
- Placenta accreta: Placenta attaches abnormally firmly to the uterine wall.
- Placenta increta: Placenta penetrates deeply into the uterine muscle.
- Placenta percreta: Placenta penetrates through the uterine wall potentially invading nearby organs.
- These conditions increase in severity as they progress through accreta, increta, and percreta (the most severe).
Risk Factors for PAS
- Previous uterine surgery (e.g., C-sections)
- Placenta previa
- Advanced maternal age
- History of multiple pregnancies
Complications of PAS
- Life-threatening maternal hemorrhage
- Large-volume blood transfusions
- Peripartum hysterectomy
- Preeclampsia
- Preterm labor
- Disseminated intravascular coagulation (DIC)
- Shock
Vasa Previa
- Vasa previa: Fetal blood vessels cross or run near the internal opening of the uterus
- Types of vasa previa:
- Velamentous insertion: Blood vessels travel from the membranes of the placenta
- Succenturiate placenta: Blood vessels originate from a separate lobe of the placenta.
- Complications: Fetal blood vessel rupture, leading to severe blood loss or fetal death. Bleeding during labor
- When diagnosed early, cesarean section is crucial to prevent life-threatening hemorrhage.
- Routine prenatal monitoring and testing (e.g. ultrasound, Doppler flow studies) aid in diagnosis.
Placental Insufficiency
- Placental insufficiency: Placenta doesn't adequately provide nutrients and oxygen to the fetus.
- Causes: Placenta damage/developmental defects.
- Symptoms: Fetal growth restriction or SGA, Decreased fetal movement, non-reassuring fetal heart rate patterns (e.g., variable decelerations). Maternal symptoms could include: hypertension, swelling, protein in urine.
- Diagnosis: Ultrasound, Doppler flow studies, non-stress tests (NST), biophysical profile (BPP).
Retained Placenta
- Definition: Part of the placenta remains in the uterus after delivery.
- Causes: Poor uterine contractions, uterine atony, placental abnormalities (e.g., accreta, increta, percreta) and prior uterine surgeries, uterine anomalies.
- Common causes, not related to the abnormalities above, include large-size babies, multiple births, extended labor, oxytocin use and magnesium sulfate infusions.
- Symptoms: Postpartum hemorrhage, difficulty in placental ejection, infection signs (e.g., fever, bad-smelling discharge), abdominal pain.
- Management: Manual removal, uterine massage, utero-tonics (e.g., oxytocin), surgical removal (e.g., curettage or hysterectomy if required), antibiotics and blood transfusions (if needed)
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