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Module 5 - Ectopic P
Ectopic Pregnancy
| Question | Answer |
|---|---|
| Placenta previa definition | Implantation in lower uterine segment |
| Types: | low-lying * Marginal * Partial * complete |
| Classic signs | painless, bright red vaginal bleeding, uterus normal tone, malpresentation |
| Pathophysiology | With increasing cervical dilation, risk for maternal hemorrhage/ fetal hypoxia or death |
| Diagnostics | NO VAGINAL EXAMS! Transabdominal ultrasound Hct/Hgb; type crossmatch blood |
| Labor management : Complete or partial | Cesarean |
| Delay birth until ____ wks if possible | 37 weeks; bedrest /w BR priv, (if not bleeding), monitor pain, EBL, contx, vitals, CBC, urinalysis, Ringer's |
| Labor management: low-lying, Marginal | Trial of labor with close monitoring of bleeding, maternal hemodynamics, fetal heart patterns |
| In later preg,. when uterus contracts and dilates, ______ ______ are torn away from the uterine wall, exposing the uterine sinuses; ____ begins | Placental villi, bleeding |
| Complete | Internal os completely covered |
| Partial | internal os partially covered |
| low-lying | placenta is implanted in lower uterine segment, not covering os |
| Risks | Blacks, prior C/S, high gravidity, high parity, +age, prior miscarriage, prev induced abort.,smoking and MALE FETUS |
| marginal | Lower edge of placenta reaches internal os, but does not cover it |
| Assessment must be_________ | ongoing |
| Dx | Fl Vol Def/Risk for impaired gas exchange/Anxiety |
| Condition associated with hemorrhage where after birth uterus contracts poorly and turns blue & hysterectomy is necessitated. | Couvelaire uterus |
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CCBCMDNursing218
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