Bleeding disorders

Abortion

— Interruption of a pregnancy before a fetus is viable

— Below 20 weeks

Threatened abortion

— Symptoms begin as vaginal bleeding, initially only scant and usually bright red

— Slight cramping, but no cervical dilatation is present on vaginal examination

— Fetus is ok

— Give tocolytic drug - terbutaline sq ½ ampule - helps relax uterus

Inevitable abortion

— Uterine contractions and cervical dilation occurs

— Dilatation and curretage to scrape fetus out if no fetus heart rate

Incomplete abortion

— Some products of conception left in uterus

— Ultrasound to check

Complete abortion

— Everything out, including placenta and fetus

Missed abortion

— Also commonly referred to as early pregnancy failure, the fetus dies in utero but is not expelled

Recurrent spontaneous abortion

— 3x miscarriage in a row

— Incompetent cervix

Ectopic pregnancy

— Happens outside the uterus

— 97% in fallopian tubes

— 3% Abdomen

Hydatidiform mole/ molar pregnancy

— Unembryonic pregnancy

— Trophoblast cells form instead of embryo

— Abdomen continues to grow

Incompetent cervix

— Cannot hold fetus - big cervix

Cervical cerclage

— Ties cervix closed till term

Mcdonald procedure

— Nylon sutures are placed horizontally and vertically across the cervix and pulled tight

Shilodkar technique

— Tying the cervix closed till term and suturing the cervix closed

Partial abruption(concealed)

— No bleeding

— Bleeding happens at the center where the placenta detached

— Baby will stop moving

Partial abruption (apparent hemorrhage)

— Bleeding at the edge

— Bleeding comes out

Complete abruption

— Concealed hemorrhage

— 5- 10 mins

— Massive internal hemorrhage

Premature rupture of membranes

— Membranes at term but amniotic sac ruptures before labor contraction begins