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Ectopic Pregnancy

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