Вы находитесь на странице: 1из 3

Bleeding Disorders of Pregnancy

Hemorrhage is defined as the rapid loss of more than 1% of body weight in blood. Rapid blood loss results in:  Inadequate tussue perfuson  Deprivation of glucose and oxygen in the tissues  Build up of waste products Hypovolemick shock occurs bleeding results in blood loss amounting to 1.5 to 2 Liters Perinatal hemorhage is hemorrhage that occurs during pregnancy, labor and delivery. 1. Antepartum hemorrhage: Refers to hemorrhage that occurs anytime during pregnancy. y Early antepartum hemorrhage (before 20 weeks gestation) may be caused by abortion, ectopic pregnancy and molar pregnancy. y Late antepartum hemorrhage (after 20 weeks gestation) may result from placental abruption and placenta previa. 2. Intrapartum hemorrhage: Hemorrhage that occurs during labor nd is most commonly due to: y Placental abruption y Uterine rupture y Uterine inversion y CS complication 3. Postpartum hemorrhage: is defined as blood loss greater than 500 ml in a vaginal delivery or 1000 ml in a ceasarian birth. y Early post partum hemorrhage occurs during the first 24 hours after delivery. The most common cause is uterine atony and lacerations. y Late post partum hemorrhage occurs during the first 24 hours after delivery and is most often due to retained placental fragment and subinvolution of the uterus. Different Bleeding Disorders of Pregnancy 1. First trimester bleeding: Abortion and Ectopic pregnancy 2. Second trimester bleeding: Hydatidiform mole and Incompetent cervix 3. Third trimester bleeding: Placenta previa and Abruptio Placenta Abortion Abortion is the termination of a pregnancy by the removal or expulsion of afetus or embryo from the uterus, before fetal viability. An abortion can occur spontaneously due to complications during pregnancy, or can be induced, in humans and in other species. In the context of human pregnancies, an abortion may be referred to as eithertherapeutic or elective. The term abortion most commonly refers to the induced abortion of ahuman pregnancy, while spontaneous abortions are usually termed miscarriages.

Ectopic Pregnancy An ectopic pregnancy, or eccysis, is a complication of pregnancy in which the pregnancy implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the mother, internal bleeding being a common complication. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.

Hydatidiform Mole/Gestational Trophoblastic Disease Molar pregnancy is an abnormal form of pregnancy, wherein a non-viable, fertilized egg implants in the uterus, and thereby converts normal pregnancy processes into pathological ones. It is characterized by the presence of a hydatidiform mole (or hydatid mole, mola hydatidosa). Molar pregnancies are categorized into partial and complete moles. Incompetent Cervix Cervical incompetence is a medical condition in which a pregnant woman's cervix begins todilate (widen) and efface (thin) before her pregnancy has reached term. Cervical incompetence may cause miscarriage or preterm birth during the second and third trimesters. In a woman with cervical incompetence, dilation and effacement of the cervix may occur without pain or uterine contractions. In a normal pregnancy, dilation and effacement occurs in response to uterine contractions. Cervical incompetence occurs because of weakness of the cervix, which is made to open by the growing pressure in the uterus as pregnancy progresses. If the responses are not halted, rupture of the membranes and birth of a premature baby can result.

Placenta Previa Placenta praevia (placenta previa AE) is an obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix. It can sometimes occur in the later part of the first trimester, but usually during the second or third. It is a leading cause ofantepartum haemorrhage (vaginal bleeding). It affects approximately 0.5% of all labours. Placenta previa is classified according to the placement of the placenta:
   

Type I or low lying: The placenta encroaches the lower segment of the uterus but does not infringe on the cervical os. Type II or marginal: The placenta touches, but does not cover, the top of the cervix. Type III or partial: The placenta partially covers the top of the cervix Type IV or complete: The placenta completely covers the top of the cervix

Abruptio Placenta Placental abruption (also known as abruptio placentae) is a complication of pregnancy, wherein the placental lining has separated from the uterus of the mother. It is the most common pathological

cause of late pregnancy bleeding. In humans, it refers to the abnormal separation after 20 weeks of gestation and prior to birth. Effect On the mother:
   

A large loss of blood or hemorrhage may require blood transfusions and intensive care after delivery. 'APH weakens for PPH to kill'. The uterus may not contract properly after delivery so the mother may need medication to help her uterus contract. The mother may have problems with blood clotting for a few days. If the mother's blood does not clot (particularly during a caesarean section) and too many transfusions could put the mother into disseminated intravascular coagulation (DIC) due to increased thromboplastin, the doctor may consider a hysterectomy.

 

A severe case of shock may affect other organs, such as the liver, kidney, and pituitary gland. Diffuse cortical necrosis in the kidney is a serious and often fatal complication. In some cases where the abruption is high up in the uterus, or is slight, there is no bleeding, though extreme pain is felt and reported.

Effect On the baby:


    

If a large amount of the placenta separates from the uterus, the baby will probably be in distress until delivery and may die in utero, thus resulting in a stillbirth. The baby may be premature and need to be placed in the newborn intensive care unit. He or she might have problems with breathing and feeding. If the baby is in distress in the uterus, he or she may have a low level of oxygen in the blood after birth. The newborn may have low blood pressure or a low blood count. If the separation is severe enough, the baby could suffer brain damage or die before or shortly after birth
     

contractions that don't stop (and may follow one another so rapidly as to seem continuous) pain in the uterus tenderness in the abdomen vaginal bleeding (sometimes) uterus may be disproportionately enlarged pallor

Prepared by:

SIELLA MAE S. VERGARA


BSN4A/Group 4

Вам также может понравиться