Obstetric Complications: Hemolysis, DIC, Placental Issues & Infections

What does HELLPP stand for in obstetric care?

H - hemolysis, E - elevated liver enzymes, L - low platelet count

What are key indicators of HELLP syndrome?

RUQ/Epigastric pain, bruising, petechiae, malaise

What interventions are recommended for HELLP syndrome?

Seizure precautions, deliver baby, blood replacement, medications like magnesium sulfate, antihypertensives, corticosteroids

What is Disseminated Intravascular Coagulation (DIC)?

A condition where the body overactivates clotting, using up clotting factors and platelets, leading to uncontrollable bleeding.

What are key indicators of DIC?

Hematuria, bruising/petechiae, hypotension, tachycardia, GI bleeding, organ failure

What interventions are necessary for DIC?

Deliver baby, administer antibiotics/fluids, stop hemorrhage

What is a key diagnostic indicator for DIC?

Fibrin split products

What is placental abruption?

Detachment of the placenta from the decidua after 20 weeks of gestation.

What are the signs and symptoms of placental abruption?

Sudden/intense abdominal pain, dark red vaginal bleeding, tender uterus

What is the treatment for mild and severe placental abruption?

Mild: monitor and administer steroids; Severe: immediate cesarean section

What is placental previa?

A condition where placental tissue overlies the internal cervix.

What are the signs and symptoms of placental previa?

Painless vaginal bleeding, bright red bleeding, non-tender uterus

What is the treatment for placental previa?

Pelvic rest, cesarean section if complete or partial, corticosteroids

How is placental previa diagnosed?

By ultrasound; no vaginal exams are performed.

What is vasa previa?

A condition where fetal blood vessels overlie the cervix.

What are the signs and symptoms of vasa previa?

No symptoms until membranes rupture, followed by immediate fetal bradycardia.

What is the treatment for vasa previa?

Corticosteroids, cesarean section at 34-37 weeks, immediate neonatal resuscitation.

What is chorioamnionitis?

An infection of the amnion or chorion (fluid) surrounding the fetus.

What are the signs and symptoms of chorioamnionitis?

Foul smelling discharge, elevated WBC (>15,000), tachycardia, uterine tenderness.

What is the treatment for chorioamnionitis?

Antibiotics such as ampicillin and gentamicin.

What temperature readings indicate a diagnosis of chorioamnionitis?

A temperature of 102.2 once or 100.4 twice.

What is PROM?

Premature rupture of membranes prior to contractions or after 37 weeks of gestation.

What is PPROM?

Preterm premature rupture of membranes, occurring before 37 weeks of gestation.

What is the treatment for PPROM?

Corticosteroids if less than 34 weeks, antibiotics, and tocolytics.