Matthew Coulson
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Bleeding in Late Pregnancy lecture given on the Thursday morning of Week 4

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Matthew Coulson
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Bleeding In Late Pregnancy

Question 1 of 43

1

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Bleeding in late pregnancy is considered as bleeding any time after ( 24 weeks, 20 weeks, 28 weeks )

Explanation

Question 2 of 43

1

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Bleeding before 24 weeks is a potential sign of ( miscarriage, foetal malformation, placental abruption, breech presentation, early labour )

Explanation

Question 3 of 43

1

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The placenta is completely formed and the sole source of foetal nutrition as of ( 6 weeks, 10 weeks, 14 weeks ) gestation

Explanation

Question 4 of 43

1

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Bleeding from the genital tract after 24 weeks gestation and before the end of the second stage of labour is known as haemorrhage

Explanation

Question 5 of 43

1

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A Major antepartum haemorrhage is considered as anything from ( 50, 100, 200, 500 )-1000ml of blood loss
Anything more than 1000ml is a Massive antepartum haemorrhage

Explanation

Question 6 of 43

1

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Premature separation of a normally implanted placenta from the uterine wall is known as placental

Explanation

Question 7 of 43

1

Which 3 of the following are the main defining symptoms of placental abruption?

Select one or more of the following:

  • Intermittent abdominal pain

  • Continuous abdominal pain

  • Bleeding

  • Headache

  • Nausea & Vomiting

  • Oliguria

  • Dysuria

  • Preterm Labour

Explanation

Question 8 of 43

1

A 'woody hard' uterus upon abdominal examination would suggest what is occurring?

Select one of the following:

  • Placental abruption

  • Placenta praevia

  • Placenta accreta

  • Vasa praevia

Explanation

Question 9 of 43

1

A woman is diagnosed with having a placental abruption. She has been highly distressed for the past 30 minutes and has just become unresponsive. You feel for a foetal pulse and feel one present. Which two of the following things should be done next?

Select one or more of the following:

  • Resuscitation of Mother

  • Delivery of Baby via Caesarean section

  • Manual removal of foetus via vagina

  • Induction of labour to promote natural birth

Explanation

Question 10 of 43

1

During a placental abruption, the foetal heart should be assessed using which means of investigation?

Select one of the following:

  • Cardiotocography (CTG)

  • Doppler Ultrasound

  • Pinard Stethoscope

Explanation

Question 11 of 43

1

After a placental abruption has occurred and been managed appropriately, which of the following is most likely to occur next?

Select one of the following:

  • Hypovolaemic shock

  • Anaemia

  • Renal failure

  • Postpartum haemorrhage (PPH)

  • Thromboembolism

Explanation

Question 12 of 43

1

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The treatment plan for antiphospholipid syndrome when looking to conceive consists of ( LMWH + Low Dose Aspirin, LMWH alone, LMWH + Warfarin, Warfarin + Low Dose Aspirin, Low Dose Aspirin alone )

Explanation

Question 13 of 43

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Which condition is characterised by implantation of the placenta in the lower uterus, sometimes covering the cervix?

Explanation

Question 14 of 43

1

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Placenta praevia typically becomes problematic when it lies over the ( internal os, external os, entrance to the fallopian tubes )

Explanation

Question 15 of 43

1

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The lower segment of the uterus is ( thinner, thicker ) and contains ( less, more ) muscle fibres than the upper segment. It also does not ( contract, dilate ) during labour.

Explanation

Question 16 of 43

1

Caesarean delivery is associated with an increased risk of placenta praevia in subsequent pregnancies.

Select one of the following:

  • True
  • False

Explanation

Question 17 of 43

1

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In terms of a method of delivery, LSCS stands for

Explanation

Question 18 of 43

1

Which mode of delivery leaves a woman at most risk of developing placenta praevia in subsequent pregnancies?

Select one of the following:

  • Spontaneous Vaginal Delivery

  • Caesarian Section

  • Induced Labour

Explanation

Question 19 of 43

1

Placenta Praevia is typically found upon which method of scanning?

Select one of the following:

  • Uterine Venography

  • Ultrasound (12 and 20 weeks)

  • Maternal blood testing at 16 weeks

Explanation

Question 20 of 43

1

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Placenta praevia typically presents as ( painless, painful ) bleeding after the ( 24th, 20th, 28th ) week. The amount of blood is typically proportional to the severity of the patient's condition.

Explanation

Question 21 of 43

1

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The uterus typically feels ( soft, hard ) in placenta praevia

Explanation

Question 22 of 43

1

CTG is usually normal in a case of placenta praevia

Select one of the following:

  • True
  • False

Explanation

Question 23 of 43

1

Vaginal examination should not be performed until placenta praevia is excluded due to risk of damage to the placenta/foetus.

Select one of the following:

  • True
  • False

Explanation

Question 24 of 43

1

Patients with placenta praevia are not advised to abstain from sexual intercourse

Select one of the following:

  • True
  • False

Explanation

Question 25 of 43

1

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For a woman going to give birth preterm, which drugs should be given for ...
Neuroprotection -
Encouraging Pulmonary Surfactant production in foetus -

Explanation

Question 26 of 43

1

A woman with an uncomplicated placenta praevia should have her baby delivered around ...

Select one of the following:

  • 36-37 weeks (pre-term)

  • 40 weeks (term)

  • 42 week (post-term)

Explanation

Question 27 of 43

1

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In women with placenta praevia:
If the placenta is >2cm from the internal os - ( vaginal birth, caesarean section ) is encouraged
If the placenta lies directly over the internal os - ( caesarean section, vaginal birth ) is encouraged

Explanation

Question 28 of 43

1

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Name the condition whereby the placenta is deeply rooted into the uterine wall and doesn't detach naturally, leading to major bleeding.

Explanation

Question 29 of 43

1

Most women who have a placenta accreta end up having a c-section w/ hysterectomy, leaving them infertile.

Select one of the following:

  • True
  • False

Explanation

Question 30 of 43

1

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In which condition of pregnancy does a full-thickness tear occur in the uterus?
Uterine

Explanation

Question 31 of 43

1

As well as the severe abdominal pain, the pain from a uterine rupture typically refers to the ...

Select one of the following:

  • Central back

  • Flank

  • Shoulder Tip

  • Epigastric region

Explanation

Question 32 of 43

1

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Unprotected foetal vessels overlying the internal os of the uterus is known as

Explanation

Question 33 of 43

1

Mortality of Vasa Praevia is fairly low at around 15%

Select one of the following:

  • True
  • False

Explanation

Question 34 of 43

1

How is Vasa Praevia typically managed?

Select one of the following:

  • Delivery via caesarean section

  • Intrauterine band ligation of blood vessels

  • Termination of pregnancy due to high risk of maternal mortality

Explanation

Question 35 of 43

1

Vasa Praevia patients should be given steroids early (around 32 weeks) to prepare for elective preterm caesarean section delivery

Select one of the following:

  • True
  • False

Explanation

Question 36 of 43

1

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Postpartum haemorrhage is defined as a blood loss of greater than ( 500ml, 250ml, 100ml, 1000ml ) following the birth of the baby

Explanation

Question 37 of 43

1

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Primary PPH = Within ( 24 hours, 3 days, 12 hours ) of delivery
Secondary = ( 24hr - 6 weeks, 12hr to 1 week, 3 days - 6 weeks ) post delivery

Explanation

Question 38 of 43

1

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A major PPH is defined as a blood loss of greater than ( 1000ml, 500ml, 750ml )

Explanation

Question 39 of 43

1

Which of the following is the main cause of PPH?

Select one of the following:

  • Uterine Atony

  • Trauma

  • Retained/abnormal placentation

  • Clotting factor abnormality

Explanation

Question 40 of 43

1

Jehovah's Witnesses are typically more difficult to treat in cases of late bleeding in pregnancy.

Select one of the following:

  • True
  • False

Explanation

Question 41 of 43

1

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Injection of a synthetic version of which human hormone is typically used to stop the bleeding in PPH?

Explanation

Question 42 of 43

1

Ergometrine can be used induce contractions in cases of PPH, thus helping to stop the bleeding. It is however contraindicated in women with ...

Select one of the following:

  • Diabetes

  • Asthma

  • Hypertension

Explanation

Question 43 of 43

1

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The laboratory test used to determine how much Anti-D a Rhesus negative woman requires to prevent isoimmunisation is called the ( Kleihauer, Klaustein, Kinnel's, Kerstiell ) test

Explanation

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