Placenta previa, abruption, uterine rupture, postpartum hemorrhage causes (the 4 T's) and treatment, shoulder dystocia, cord prolapse and amniotic fluid embolism.
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- What is placenta previa?
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The placenta covers or lies abnormally close to the internal cervical os.- What is the classic presenting symptom of placenta previa?
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Painless vaginal bleeding in the third trimester.- Name two major risk factors for placenta previa.
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Prior cesarean section and multiparity.- Why is a digital cervical exam avoided when placenta previa is suspected?
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It can provoke severe hemorrhage by disrupting the placenta over the cervix.- What is placental abruption?
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Premature separation of the placenta from the uterine wall before delivery.- What is the classic presentation of placental abruption?
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Painful vaginal bleeding with a tender, rigid uterus.- Name two major risk factors for placental abruption.
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Hypertension (including preeclampsia) and cocaine use.- What severe coagulation complication can result from placental abruption?
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Disseminated intravascular coagulation (DIC).- What is uterine rupture?
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A full-thickness tear through the uterine wall during pregnancy or labor.- What is the most common risk factor for uterine rupture?
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A prior cesarean section scar, especially during a trial of labor after cesarean.- What fetal heart rate finding often signals uterine rupture?
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Sudden fetal bradycardia.- What is the emergency treatment for uterine rupture?
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Immediate emergency laparotomy and delivery.- How is postpartum hemorrhage typically defined?
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Blood loss of 1000 mL or more, or any amount causing signs of hypovolemia, after delivery.- What does the 4 T's mnemonic stand for in postpartum hemorrhage causes?
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Tone, Trauma, Tissue, and Thrombin.- What is the most common cause of postpartum hemorrhage?
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Uterine atony, the Tone category.
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