General Concepts
Two major types of antepartum hemorrhage
Placenta Previa and Placental Abruption
hallmark symptom of placenta previa
painless, bright red vaginal bleeding
hallmark symptom of placenta abruption
painful, dark red vaginal bleeding
most common location for ectopic pregnancy
fallopian tube
lab test that is monitored after molar pregnancy evacuation
serial hCG testing
Most common cause of bleeding in the first trimester
Miscarriage or ectopic pregnancy
procedure to be avoided in patients with placenta previa
cervical/vaginal exams
clinical manifestation for placenta abruption
rigid, board like abdomen; fetal distress
treatment for complete molar pregnancy
suction curettage
priority nursing intervention for a patient who presents with vaginal bleeding to triage
assess fetal heart rate
Most reliable indicator of maternal blood loss
diagnostic test for placenta previa
ultrasound
major risk factor risk factor for placenta abruption
uncontrolled hypertension or preeclampsia
manifestations of rupture ectopic pregnancy
sudden shoulder pain; signs of shock
post operative nursing care following surgery for molar pregnancy
pain management; reporting complications; monitoring bleeding
Concealed Hemorrhage definition
blood loss occurring behind the placenta that is not visible vaginally
recommended delivery type for placenta previa
cesarean delivery
two complications resulting from placenta previa
maternal hemorrhage; DIC
should be avoided for 6-12 months after evacuation of molar pregnancy
pregnancy
expectant management for ectopic pregnancy
monitoring the client while waiting for ectopic pregnancy to resolve on its own
lab tests that evaluates for DIC
Fibrinogen, PT, aPTT and platelet count
two major risk factors for placenta previa
previous cesarean delivery & multiple gestation (also advanced maternal age)
street drug that causes intense systemic vasoconstriction, is the leading preventable cause of placental abruption due to acute vasospasm in the placental bed
cocaine
ectopic pregnancy symptoms triad
abdominal pain, amenorrhea, vaginal bleeding
therapeutic use of methotrexate for ectopic pregnancy
to stop the growth of rapidly dividing cells (developing embryo)