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Bleeding In Late Pregnancy

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Bleeding in Late Pregnancy lecture given on the Thursday morning of Week 4
Matthew Coulson
Quiz by Matthew Coulson, updated more than 1 year ago
Matthew Coulson
Created by Matthew Coulson almost 6 years ago
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Resource summary

Question 1

Question
Bleeding in late pregnancy is considered as bleeding any time after [blank_start]24 weeks[blank_end]
Answer
  • 24 weeks
  • 20 weeks
  • 28 weeks

Question 2

Question
Bleeding before 24 weeks is a potential sign of [blank_start]miscarriage[blank_end]
Answer
  • miscarriage
  • foetal malformation
  • placental abruption
  • breech presentation
  • early labour

Question 3

Question
The placenta is completely formed and the sole source of foetal nutrition as of [blank_start]6 weeks[blank_end] gestation
Answer
  • 6 weeks
  • 10 weeks
  • 14 weeks

Question 4

Question
Bleeding from the genital tract after 24 weeks gestation and before the end of the second stage of labour is known as [blank_start]antepartum[blank_end] haemorrhage
Answer
  • antepartum

Question 5

Question
A Major antepartum haemorrhage is considered as anything from [blank_start]50[blank_end]-1000ml of blood loss Anything more than 1000ml is a Massive antepartum haemorrhage
Answer
  • 50
  • 100
  • 200
  • 500

Question 6

Question
Premature separation of a normally implanted placenta from the uterine wall is known as placental [blank_start]abruption[blank_end]
Answer
  • abruption

Question 7

Question
Which 3 of the following are the main defining symptoms of placental abruption?
Answer
  • Intermittent abdominal pain
  • Continuous abdominal pain
  • Bleeding
  • Headache
  • Nausea & Vomiting
  • Oliguria
  • Dysuria
  • Preterm Labour

Question 8

Question
A 'woody hard' uterus upon abdominal examination would suggest what is occurring?
Answer
  • Placental abruption
  • Placenta praevia
  • Placenta accreta
  • Vasa praevia

Question 9

Question
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?
Answer
  • Resuscitation of Mother
  • Delivery of Baby via Caesarean section
  • Manual removal of foetus via vagina
  • Induction of labour to promote natural birth

Question 10

Question
During a placental abruption, the foetal heart should be assessed using which means of investigation?
Answer
  • Cardiotocography (CTG)
  • Doppler Ultrasound
  • Pinard Stethoscope

Question 11

Question
After a placental abruption has occurred and been managed appropriately, which of the following is most likely to occur next?
Answer
  • Hypovolaemic shock
  • Anaemia
  • Renal failure
  • Postpartum haemorrhage (PPH)
  • Thromboembolism

Question 12

Question
The treatment plan for antiphospholipid syndrome when looking to conceive consists of [blank_start]LMWH + Low Dose Aspirin[blank_end]
Answer
  • LMWH + Low Dose Aspirin
  • LMWH alone
  • LMWH + Warfarin
  • Warfarin + Low Dose Aspirin
  • Low Dose Aspirin alone

Question 13

Question
Which condition is characterised by implantation of the placenta in the lower uterus, sometimes covering the cervix? [blank_start]Placenta Praevia[blank_end]
Answer
  • Placenta Praevia

Question 14

Question
Placenta praevia typically becomes problematic when it lies over the [blank_start]internal os[blank_end]
Answer
  • internal os
  • external os
  • entrance to the fallopian tubes

Question 15

Question
The lower segment of the uterus is [blank_start]thinner[blank_end] and contains [blank_start]less[blank_end] muscle fibres than the upper segment. It also does not [blank_start]contract[blank_end] during labour.
Answer
  • contract
  • dilate
  • thinner
  • thicker
  • less
  • more

Question 16

Question
Caesarean delivery is associated with an increased risk of placenta praevia in subsequent pregnancies.
Answer
  • True
  • False

Question 17

Question
In terms of a method of delivery, LSCS stands for [blank_start]lower segment caesarean section[blank_end]
Answer
  • lower segment caesarean section

Question 18

Question
Which mode of delivery leaves a woman at most risk of developing placenta praevia in subsequent pregnancies?
Answer
  • Spontaneous Vaginal Delivery
  • Caesarian Section
  • Induced Labour

Question 19

Question
Placenta Praevia is typically found upon which method of scanning?
Answer
  • Uterine Venography
  • Ultrasound (12 and 20 weeks)
  • Maternal blood testing at 16 weeks

Question 20

Question
Placenta praevia typically presents as [blank_start]painless[blank_end] bleeding after the [blank_start]24th[blank_end] week. The amount of blood is typically proportional to the severity of the patient's condition.
Answer
  • painless
  • painful
  • 24th
  • 20th
  • 28th

Question 21

Question
The uterus typically feels [blank_start]soft[blank_end] in placenta praevia
Answer
  • soft
  • hard

Question 22

Question
CTG is usually normal in a case of placenta praevia
Answer
  • True
  • False

Question 23

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

Question 24

Question
Patients with placenta praevia are not advised to abstain from sexual intercourse
Answer
  • True
  • False

Question 25

Question
For a woman going to give birth preterm, which drugs should be given for ... Neuroprotection - [blank_start]Magnesium Sulphate[blank_end] Encouraging Pulmonary Surfactant production in foetus - [blank_start]Steroids[blank_end]
Answer
  • Magnesium Sulphate
  • Steroids

Question 26

Question
A woman with an uncomplicated placenta praevia should have her baby delivered around ...
Answer
  • 36-37 weeks (pre-term)
  • 40 weeks (term)
  • 42 week (post-term)

Question 27

Question
In women with placenta praevia: If the placenta is >2cm from the internal os - [blank_start]vaginal birth[blank_end] is encouraged If the placenta lies directly over the internal os - [blank_start]caesarean section[blank_end] is encouraged
Answer
  • vaginal birth
  • caesarean section
  • caesarean section
  • vaginal birth

Question 28

Question
Name the condition whereby the placenta is deeply rooted into the uterine wall and doesn't detach naturally, leading to major bleeding. [blank_start]Placenta Accreta[blank_end]
Answer
  • Placenta Accreta

Question 29

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

Question 30

Question
In which condition of pregnancy does a full-thickness tear occur in the uterus? Uterine [blank_start]rupture[blank_end]
Answer
  • rupture

Question 31

Question
As well as the severe abdominal pain, the pain from a uterine rupture typically refers to the ...
Answer
  • Central back
  • Flank
  • Shoulder Tip
  • Epigastric region

Question 32

Question
Unprotected foetal vessels overlying the internal os of the uterus is known as [blank_start]vasa praevia[blank_end]
Answer
  • vasa praevia

Question 33

Question
Mortality of Vasa Praevia is fairly low at around 15%
Answer
  • True
  • False

Question 34

Question
How is Vasa Praevia typically managed?
Answer
  • Delivery via caesarean section
  • Intrauterine band ligation of blood vessels
  • Termination of pregnancy due to high risk of maternal mortality

Question 35

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

Question 36

Question
Postpartum haemorrhage is defined as a blood loss of greater than [blank_start]500ml[blank_end] following the birth of the baby
Answer
  • 500ml
  • 250ml
  • 100ml
  • 1000ml

Question 37

Question
Primary PPH = Within [blank_start]24 hours[blank_end] of delivery Secondary = [blank_start]24hr - 6 weeks[blank_end] post delivery
Answer
  • 24 hours
  • 3 days
  • 12 hours
  • 24hr - 6 weeks
  • 12hr to 1 week
  • 3 days - 6 weeks

Question 38

Question
A major PPH is defined as a blood loss of greater than [blank_start]1000ml[blank_end]
Answer
  • 1000ml
  • 500ml
  • 750ml

Question 39

Question
Which of the following is the main cause of PPH?
Answer
  • Uterine Atony
  • Trauma
  • Retained/abnormal placentation
  • Clotting factor abnormality

Question 40

Question
Jehovah's Witnesses are typically more difficult to treat in cases of late bleeding in pregnancy.
Answer
  • True
  • False

Question 41

Question
Injection of a synthetic version of which human hormone is typically used to stop the bleeding in PPH? [blank_start]Oxytocin[blank_end]
Answer
  • Oxytocin

Question 42

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

Question 43

Question
The laboratory test used to determine how much Anti-D a Rhesus negative woman requires to prevent isoimmunisation is called the [blank_start]Kleihauer[blank_end] test
Answer
  • Kleihauer
  • Klaustein
  • Kinnel's
  • Kerstiell
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