Hemorrhagic Conditions of Pregnancy

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Hemorrhagic Conditions of Pregnancy
2015-04-02 22:43:14
Hemorrhagic pregnancy

Hemorrhagic conditions of pregnancy
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  1. Threatened AB
    • Possible termination of products of conception
    • Cervix is closed
    • Mild cramping
    • process could be stopped
    • watchful optimism
    • bright pink-red spotting
  2. Inevitable AB
    • Termination of products of conception
    • Cervix is dilated
    • process can't be stopped
    • moderate to copious bleeding that may contain tissue
    • severe cramping
    • grief support
  3. Incompetent Cervix
    • Defect in the cervix
    • painless dilation of cervix
    • no contractions occur
    • place mother in trendelenburg and monitor FHR
    • Tocolytics: to prevent aggravation to uterus
    • Cerclage: suture cervix to maintain pregnancy
  4. H Mole
    • Proliferation of trophoblastic cells resulting in an invasive tumor and non-viable pregnancy
    • Very high HCG levels
    • snow storm ultrasound
    • grapelike vesicles and prune colored vaginal discharge
    • no pregnancy for year after- continued monitoring
    • do not induce labor, give oxytocin following the removal of mole
  5. Placenta previa
    • placenta attached to lower uterine segment
    • diagnosed around 28-29 weeks after occurrence of bleeding
    • no vaginal exams
    • normal uterine resting tone and FHR
    • often results in c-section
    • give ongoing emotional support
  6. Abruptio Placenta
    • Premature separation of normally implanted placenta
    • Apparent: bleeding freely, not as painful
    • Concealed: no visible blood, extreme pain, blood is trapped
    • High resting tone and fetal distress, may have rigid abdomen
    • Large Bore IV, type and cross, H&H, coag studies
    • get to OR fast, listen to your patient!