OB Complications pt 1 ACTUAL
QUESTIONS AND CORRECT ANSWERS
Obstetrical Hemorrhage
__% of women have bleeding during early pregnancy
__% will have spontaneous abortion
__% continue with a normal pregnancy - CORRECT ANSWERS 20
75
25
2 MC causes of hemorrhage in the 3rd trimester - CORRECT ANSWERS Placenta Previa
Placental Abruption
what is Placenta Previa? - CORRECT ANSWERS abnormal implantation of placenta over
or in close proximity to the internal cervical os
lowest risk for Placenta Previa?
greatest risk?
incidence rates for each? - CORRECT ANSWERS primigravidas - 1 in 1000
grand multiparas (5+ babies) - 1 in 20.
__% of early ultrasounds may show placenta previa
Later sonograms reveal what?
__-__% recurrence rate - CORRECT ANSWERS 5;
a "migration" of the placenta;
,4-8
4 types of Placenta Previa? - CORRECT ANSWERS 1. Complete - entire cervix is
covered
2. Partial - Placenta extends across part of internal os
3. Marginal - edge of placenta lies adj to internal os
4. Low lying - placenta located near (not directly adj) to internal os
RFs for Placenta Previa? - CORRECT ANSWERS Increasing maternal age
Increasing parity
Previous Cesarean sections
Multiple Gestations
S&S for Placenta Previa? - CORRECT ANSWERS painless, bright red bleeding
diagnostics for Placenta Previa? - CORRECT ANSWERS Sonogram is extremely
beneficial in making the diagnosis
what should not be done for a Placenta Previa pt? - CORRECT ANSWERS *Digital exam
of a bleeding pt* is *contra-indicated* until can r/o placenta previa!!!
Average gestational age of 1st bleeding in Placenta Previa?
what is characteristic of this episode? - CORRECT ANSWERS 29 to 30 weeks;
almost always spontaneously stops
, what usually causes bleeding in Placenta Previa? - CORRECT ANSWERS separation of
the placenta from its attachment, the blood is usually of maternal origin
1 line tx for Placenta Previa? - CORRECT ANSWERS 1. initial hospitalization w
hemodynamic stabilization
2. if bleeding stops - expectant management until lung maturity is assured.
ideal management for for Placenta Previa? - CORRECT ANSWERS bed rest in the
hospital, with ready access to emergency care
when can a pt go home (as opposed to inpt) in tx of for Placenta Previa? - CORRECT
ANSWERS selected highly motivated pts
Instructions for home management of Placenta Previa? - CORRECT ANSWERS 1.
restriction of activity
2. constant attendance of an adult
3. pelvic rest (no sexual intercourse)
4. presence of ready transportation to the hospital
Placenta Previa
maternal mortality is < __%
The perinatal mortality is < __% - CORRECT ANSWERS 1%
10%
when can we continue expectant management in Placenta Previa? - CORRECT
ANSWERS continued until 36 weeks or until a 2nd bleeding episode.
QUESTIONS AND CORRECT ANSWERS
Obstetrical Hemorrhage
__% of women have bleeding during early pregnancy
__% will have spontaneous abortion
__% continue with a normal pregnancy - CORRECT ANSWERS 20
75
25
2 MC causes of hemorrhage in the 3rd trimester - CORRECT ANSWERS Placenta Previa
Placental Abruption
what is Placenta Previa? - CORRECT ANSWERS abnormal implantation of placenta over
or in close proximity to the internal cervical os
lowest risk for Placenta Previa?
greatest risk?
incidence rates for each? - CORRECT ANSWERS primigravidas - 1 in 1000
grand multiparas (5+ babies) - 1 in 20.
__% of early ultrasounds may show placenta previa
Later sonograms reveal what?
__-__% recurrence rate - CORRECT ANSWERS 5;
a "migration" of the placenta;
,4-8
4 types of Placenta Previa? - CORRECT ANSWERS 1. Complete - entire cervix is
covered
2. Partial - Placenta extends across part of internal os
3. Marginal - edge of placenta lies adj to internal os
4. Low lying - placenta located near (not directly adj) to internal os
RFs for Placenta Previa? - CORRECT ANSWERS Increasing maternal age
Increasing parity
Previous Cesarean sections
Multiple Gestations
S&S for Placenta Previa? - CORRECT ANSWERS painless, bright red bleeding
diagnostics for Placenta Previa? - CORRECT ANSWERS Sonogram is extremely
beneficial in making the diagnosis
what should not be done for a Placenta Previa pt? - CORRECT ANSWERS *Digital exam
of a bleeding pt* is *contra-indicated* until can r/o placenta previa!!!
Average gestational age of 1st bleeding in Placenta Previa?
what is characteristic of this episode? - CORRECT ANSWERS 29 to 30 weeks;
almost always spontaneously stops
, what usually causes bleeding in Placenta Previa? - CORRECT ANSWERS separation of
the placenta from its attachment, the blood is usually of maternal origin
1 line tx for Placenta Previa? - CORRECT ANSWERS 1. initial hospitalization w
hemodynamic stabilization
2. if bleeding stops - expectant management until lung maturity is assured.
ideal management for for Placenta Previa? - CORRECT ANSWERS bed rest in the
hospital, with ready access to emergency care
when can a pt go home (as opposed to inpt) in tx of for Placenta Previa? - CORRECT
ANSWERS selected highly motivated pts
Instructions for home management of Placenta Previa? - CORRECT ANSWERS 1.
restriction of activity
2. constant attendance of an adult
3. pelvic rest (no sexual intercourse)
4. presence of ready transportation to the hospital
Placenta Previa
maternal mortality is < __%
The perinatal mortality is < __% - CORRECT ANSWERS 1%
10%
when can we continue expectant management in Placenta Previa? - CORRECT
ANSWERS continued until 36 weeks or until a 2nd bleeding episode.
