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Threatened AB
- Possible termination of products of conception
- Cervix is closed
- Mild cramping
- process could be stopped
- watchful optimism
- bright pink-red spotting
-
Inevitable AB
- Termination of products of conception
- Cervix is dilated
- process can't be stopped
- moderate to copious bleeding that may contain tissue
- severe cramping
- grief support
-
Incompetent Cervix
- Defect in the cervix
- painless dilation of cervix
- no contractions occur
- place mother in trendelenburg and monitor FHR
- Tocolytics: to prevent aggravation to uterus
- Cerclage: suture cervix to maintain pregnancy
-
H Mole
- Proliferation of trophoblastic cells resulting in an invasive tumor and non-viable pregnancy
- Very high HCG levels
- snow storm ultrasound
- grapelike vesicles and prune colored vaginal discharge
- no pregnancy for year after- continued monitoring
- do not induce labor, give oxytocin following the removal of mole
-
Placenta previa
- placenta attached to lower uterine segment
- diagnosed around 28-29 weeks after occurrence of bleeding
- no vaginal exams
- normal uterine resting tone and FHR
- often results in c-section
- give ongoing emotional support
-
Abruptio Placenta
- Premature separation of normally implanted placenta
- Apparent: bleeding freely, not as painful
- Concealed: no visible blood, extreme pain, blood is trapped
- High resting tone and fetal distress, may have rigid abdomen
- Large Bore IV, type and cross, H&H, coag studies
- get to OR fast, listen to your patient!
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