Vaginal Bleeding

Painful vaginal bleeding

• Uterus causes
  
• Mom’s Blood
  
• NOT the previa diseases

Painless vaginal bleeding

• Placental causes
  
• Baby’s Blood
  
• The Previa Diseases

Placenta Previa

• Path: Multi-gravis, multiple gestations, placenta implants at os, cervix dilates which causes a tear and leads to bleeding
  
• Pt: Painless vaginal bleeding
  
• Dx: u/s = transverse lie, NST/CST, fetal distress
  
• Tx: C-section

Vasa Previa

• Path: Accessory lobe plants across os, blood besides tear as cervix dialates and cause bleeding
  
• Pt: Painless bleeding
• Dx: NST/CST = fetal distress
  
• Tx: Uergen C-section

Placental Abruption

• Path: HTN/Cocaine, MVA, Rips placenta off, mom’s blood
  
• Pt: Painful bleeding (can be concealed)
  
• Dx: U/S, CST/NST, vitals, Hgb
  
• Tx: C-section

Uterine Rupture

• Path: Vaginal birth after C-section (attempt)
  
• C-section scar on uterus
  
• Oxytocin (because this increases the power of contractions); the uterus ruptures apart
  
• Pt: + Contractions, VERY PAINFUL, loss of fetal station
  
• Dx: None
  
• Tx: Crash Section