30 Questions
What is the primary cause of an incompetent cervix?
Trauma to the cervix
Which type of cerclage involves permanent suturing of the cervix?
Shirodkar cerclage
What is the most common cause of habitual abortion according to the text?
Trauma to the cervix
What are the signs of placenta previa?
Placental edges near the cervix
What is the effect of incompetent cervix on the fetus?
Small for Gestational Age due to lack of blood supply
What is characteristic of missed abortion according to the text?
Fetus dies in uterus with a closed cervix
What is the main cause of PIH (Pregnancy Induced Hypertension) according to the text?
Presence of the placenta
Which condition is characterized by a seizure in pregnant women suffering from PIH?
Eclampsia
What symptom is indicative of severe pre-eclampsia?
Platelet bleeding
What is the management approach recommended for mild preeclampsia/Gestational Hypertension?
Right side lying position
What type of muscle contraction is associated with the Clonic phase of an Eclamptic Seizure?
Alternating contraction and relaxation
What is the role of CHON in PIH according to the text?
Measures osmotic pressure
What is a risk factor associated with placental malfunction due to antiphospholipid syndrome?
Low socioeconomic condition and poor diet
Which infection is associated with Toxoplasmosis, a potential risk factor for placental malfunction?
Protozoa from cat litter
What does a snowstorm pattern, characterized by clusters of grape-like vesicles, signify in the context of pregnancy complications?
Infection with Cyto megalo virus (CMV)
What is the management approach for a threatened abortion characterized by uterine cramping and vaginal bleeding but with a closed cervix?
Bed rest for 48 hours and no coitus for 2 weeks
What type of abortion involves uterine cramping with an open cervix and ruptured membranes?
Inevitable abortion
Why must HCG levels be monitored for up to 1 year following an induced abortion?
To verify the absence of Choriocarcinoma
What is the purpose of administering betamethasone in the context provided?
To prevent the respiratory distress syndrome of newborn if less than 34 weeks
What is the recommended initial management for uterine atony?
Begin massaging the fundus if soft
Which of the following best describes the characteristic of a late deceleration in fetal heart rate?
FHR drops after contraction
What is the most appropriate action if the fundus is firm and there is no uterine atony?
Check for laceration
What is indicated by an increased fetal heart rate according to the information provided?
Fetal movement
Which condition should be suspected if hypovolemia and infection are present, along with rectal pain?
Hematoma
In postpartum hemorrhage, how much blood loss defines the condition according to the text?
More than 500 ml in NSD and more than 1000 ml in cesarean section (CS)
What is the appropriate management for umbilical cord prolapse during delivery?
Avoid handling the cord to reduce vasospasm
Which of the following characteristics best describes the 'taking-in' stage of postpartum emotion according to the information?
Passive, focusing on self, wanting rest and food
Which heart condition presents a higher risk of premature birth during pregnancy?
Congenital heart disease
What is the role of terbutaline in the context provided?
To stop uterine contractions
What characterizes the different stages of lochia postpartum?
Rubra, Seros, Alba
Study Notes
Placental Malfunction
- Antiphospholipid syndrome (APAS) is an autoimmune response where the body attacks the placenta, putting the pregnancy at risk.
- Risk factors for APAS include:
- Cigarette smoking
- Low socioeconomic condition
- Lack of prenatal check-ups
- Previous history of miscarriage
- Infections such as Toxoplasmosis, HIV, Hepatitis B, and Syphilis
- Signs and symptoms of APAS include:
- Positive pregnancy test
- Increased HCG levels
- Excessive vomiting leading to metabolic alkalosis
- Abdominal enlargement
- Vaginal bleeding with vesicles
- Ultrasound showing no fetal heart tone or outline
Types of Abortion
- Spontaneous abortion: naturally occurring
- Induced abortion: intentionally done to save the life of the mother
- Threatened abortion: uterine cramping and vaginal bleeding with a closed cervix
- Inevitable abortion: uterine cramping with an open cervix
- Complete abortion: all products expelled with a closed cervix
- Incomplete abortion: not all products expelled with an open cervix
- Habitual abortion: multiple consecutive spontaneous abortions
- Missed abortion: fetus dies in the uterus with a closed cervix
Causes of Abortion
- Uterine anomalies
- Multiparity (more than 4 pregnancies)
- Twins (dizygotic or fraternal)
- Antiphospholipid syndrome (APAS)
Incompetent Cervix
- Premature dilation of the cervix
- Cause: trauma to the cervix
- Effect: habitual abortion
- Signs and symptoms:
- Vaginal bleeding
- Small for gestational age fetus
- Hemorrhage
- Management:
- Bed rest
- Avoid heavy lifting
- Cerclage (suturing of the cervix)
Placenta Previa
- Low implantation of the placenta
- Types:
- Low-lying
- Partial
- Management:
- Bed rest
- Avoid heavy lifting
- Terbutaline (tocolytic) to stop uterine contraction
Cord Prolapse
- Decreased fetal heart tone (FHT) with variable deceleration
- Management:
- Position the mother into a knee-chest, face down position
- Continue to digitally relieve the pressure on the cord
- Avoid handling the cord to reduce vasospasm
- Increase IV rate and administer oxygen by face mask
- Discontinue oxytocin infusion
Post-Partum
- Uterus:
- Palpate fundus in the umbilicus on the day of delivery
- Decrease by 1 cm per day
- Post-partum depression (PPD):
- Sudden crying
- Severe sadness lasting for 6 months
- Needs support and antidepressant drugs
Post-Partum Hemorrhage
- Blood loss of more than 500 ml (NSD) or 1000 ml (CS)
- Causes:
- PIH (Pregnancy Induced Hypertension)
- Uterine atony
- Laceration
- Blood disorder
- Retained placental fragments
Pregnancy Induced Hypertension (PIH)
- Cause: unknown, but related to pregnancy and placenta
- Effects:
- Vasospasm and vasoconstriction
- Decreased blood supply to the kidney
- Proteinuria
- Edema
- Types:
- Gestational hypertension
- Pre-eclampsia
- Eclampsia
Management of PIH
- Mild preeclampsia/gestational hypertension:
- Bed rest
- Adequate protein intake
- Observation and report of signs and symptoms of severe preeclampsia
- Severe preeclampsia:
- Provide a quiet environment
- Decrease stimuli
- Uterine atony management
Additional Information
- Umbilical cord prolapse: when the umbilical cord exits through the open cervix into the vagina before the baby moves into the birth canal
- Cardiac disease during pregnancy:
- Congenital heart disease is the most common heart condition during pregnancy
- Risk factors: premature birth, abnormal heart rhythm, and heart failure
Test your knowledge on managing postpartum hemorrhage scenarios including uterine atony, laceration, blood disorders, and retained placental fragments. Learn about assessing fundus firmness, recognizing bleeding patterns like Lochia Rubra, Seros, and Alba, and taking appropriate actions in different situations.
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