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Placental Abruption and Placenta Previa Flashcards
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Placental Abruption and Placenta Previa Flashcards
Placental Abruption and Placenta Previa Flashcards
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1
Question
What is the primary origin of blood in the retroplacental hematoma in a non-traumatic placental abruption?
Answer
Maternal origin due to separation within the maternal decidua.
2
Question
In a study at Parkland Hospital, what percentage of women with non-traumatic placental abruption experienced fetal-maternal hemorrhage?
Answer
20%
3
Question
What does a placental abruption look like on the surface of a freshly expelled placenta?
Answer
Depression on the maternal surface covered with dark, clotted blood.
4
Question
Why is it important to measure fibrinogen concentrations in women with placental abruption?
Answer
Coagulation problems and potential surgical site bleeding.
5
Question
Name the maternal sequelae that defines severe placental abruption.
Answer
Shock, DIC, Transfusion, Hysterectomy, Renal failure or death.
6
Question
Name the fetal sequelae that defines severe placental abruption.
Answer
Fetal distress, growth restriction or death.
7
Question
What usually causes traumatic placental abruption?
Answer
External trauma, often from motor vehicle accidents or assaults.
8
Question
Following abdominal trauma, what is the most important indicator of placental abruption?
Answer
Uterine contractions.
9
Question
What is associated with chronic placental abruption?
Answer
Elevated levels of aneuploidy markers, first and second trimester bleeding.
10
Question
What is the reported incidence of placental abruption?
Answer
0.5% or 1 case in 200 births, but varies depending on diagnostic criteria.
11
Question
What demographic factor increases the risk of placental abruption, according to the text?
Answer
Advanced maternal age.
12
Question
List several risk factors for placental abruption from the provided table.
Answer
Prior placental abruption, advanced age, preeclampsia, chronic hypertension, chorioamnionitis, PROM, multiple pregnancy, low birth weight, polyhydramnios, smoking, single umbilical artery, cocaine use, uterine leiomyoma, subchorionic hematoma.
13
Question
What pregnancy-related condition is most commonly associated with placental abruption?
Answer
Hypertension (gestational, preeclampsia, chronic hypertension, or a combination).
14
Question
What medications may reduce the risk of placental abruption according to the text?
Answer
Magnesium sulfate and acetylsalicylic acid.
15
Question
What could be a triggering factor in PROM that causes placental abruption?
Answer
Sudden uterine decompression.
16
Question
What is the risk of recurrence with a prior history of placental abruption?
Answer
The risk of recurrence is elevated.
17
Question
Given the risk of recurrence, what is the recommended management of subsequent pregnancies after a placental abruption?
Answer
Induction of labor around 37-38 weeks of gestation.
18
Question
What lifestyle factor is linked to an elevated risk of placental abruption?
Answer
Smoking.
19
Question
What substance abuse is linked to placental abruption?
Answer
Cocaine abuse.
20
Question
What are the characteristic signs and symptoms of placental abruption?
Answer
Sudden abdominal pain, vaginal bleeding, and uterine tenderness.
21
Question
What is a major complication observed with placental abruption and is the most common cause in obstetrics?
Answer
Coagulopathy of consumption.
22
Question
Why is coagulopathy more likely with a concealed abruption?
Answer
High intrauterine pressure forces more thromboplastin into maternal veins.
23
Question
What condition can Couvelaire uterus lead to?
Answer
Uterine atony.
24
Question
What is a common cause of Acute Kidney Injury (AKI)?
Answer
Hypovolemia.
25
Question
What diagnostic test has limited use for placental abruption and what is its sensitivity?
Answer
Sonography, which has limited use with a sensitivity of only 24%.
26
Question
What is the traditional teaching with uterine bleeding in placental abruption?
Answer
Painful uterine bleeding.
27
Question
How should a viable fetus with placental abruption be delivered?
Answer
Emergency cesarean delivery.
28
Question
What treatment is placental abruption an indication for in the newborn?
Answer
Hypothermia
29
Question
How is hemostasis achieved at the placental implantation site after vaginal delivery?
Answer
Uterine contractions and compression of the myometrium.
30
Question
What procedure has long been recommended during vaginal delivery for placental abruption?
Answer
Amniotomy.