The obstetric bleeding in the second half of pregnancy

! The patient with a histologically confirmed diagnosis of trophoblastic disease, molar pregnancy after curettage of the uterus needs in defining the next hormone in dynamic

* +Chorionic gonadotropin

* Follicle Stimulating Hormone

* Progesterone

* Testosterone

* Prolactin

! On 11^th week of gestation after ultrasound the molar pregnancy was diagnosed. Future tactics

* Extirpation of uterus without appendages

* Prolongation of pregnancy

* Amputation of uterus without appendages

* +Curettage of cavity of the uterus

* Chemotherapy

!The placenta previa is localized

* on the fundus of the uterus

* at the posterior side of the uterus

* at the lateral side of the uterus

* at the anterior side of the uterus

* +In the lower segment of the uterus, blocking the internal os of the uterus

! At the case of low placentation the lower edge of the placenta is located from the internal os of uterus at a distance less than (cm)

* 9

* +7

* 5

* 3

* 2

! One of the causes of placenta previa is

* Chromosomal abnormalities

* Oligohydramnios, polyhydramnios

* Wrong position of fetus

* Congenital malformations of the fetus

* +inflammation processes of the endometrium

! The informative method of diagnosis of placenta previa is

* Anamnesis

* Viewing by the gynecological mirrors

* Vaginal examination

* +Ultrasonography

* External obstetrical examination

! A pregnant woman came to maternity hospital complaining on weakness, profuse bleeding from the genital tract. The individual card of the patient says that 2 days before, during the previous visit on 35 weeks of pregnancy, total placenta previa was diagnosed. The future tactics is

* Spontaneous labor

* Preserving therapy

* Amniotomy, induction of labor

* Caesarean section in a planned way

* +Cesarean section in a emergency way

! The main clinical symptom of placenta previa is

* Acute pain

* Disturbance of fetal heart rhythm

* Untimely rupture of membranes

* Local tenderness of the uterus and uterine tension

* +Bleeding from the genital tract on the background of complete rest

! The main clinical symptom of placenta previa is

* +Repeated bleeding from the genital tract

* Local tenderness and tension of the uterus

* Prenatal amniorrhea

* Disturbance of fetal heart rhythm

* The spherical shape of the uterus

! The highest value in the choice of tactic of antenatal care with placenta previa is the

* status of the fetus

* presentation of the fetus

* age of the pregnant

* status of the cervix

* +intensity of bleeding

! The most common complication of placenta previa is

* Inversion of the uterus

* +Placenta accreta

* Placenta adhaerens

* Prenatal amniorrhea

* Abruptio placentae

! A characteristic for the localization of the placenta at the anterior wall of the uterus and abruptio placentae is

* Prenatal amniorrhea

* Oedema at the anterior abdominal wall

* +Local tenderness

* Colicky pains

* Hypotension of uterus

! During surgery of caesarean section, produced in connection with a complete placenta previa, at the delivery of the placenta profuse bleeding begins, the placenta is not separated, which indicates the

* Atonic hemorrhage

* Violation of delivery of the placenta

* Placenta adhaerens

* +Placentae accretaecerae

* Abruptio placentae

! The main clinical symptom of abruptio placentaeis

* Symptom of "an hourglass"

* Birth activity anomaly

* Prenatal amniorrhea

* +Local tenderness and tension of the uterus

* Bleeding from the genital tract amid complete rest

! The high risk of abruptio placentaeis can be found in pregnant woman with

* anemia

* narrow pelvis

* +preeclampsia

* large fetus

* earlytoxicosis

! A pregnant women at her 37 week of pregnancy with placenta previa bleeds from the genital tract in amount of 250 ml. The future tactic is

* Treatment in day hospital

* Hospitalization, caesarean section in a planned way

* Hospitalization, cesarean section at week 40

* +Hospitalization, emergency cesarean section

* Hospitalization, observation until spontaneous labor

! The obstetric tactic in the case of abruptio placentae in the first period of labor is

* Forceps

* Vacuum extraction of the fetus

* Operation destroying the fetus

* Induction of labor with oxytocin

* +Emergency caesarean section

! Most often the placental abruption occurs in the second period of labor with

* Chorioamnionitis in labor

* +Absolute / relative short umbilical cord

* Weakness of birth activity

* Placentae accretaecerae

* Prenatal amniorrhea

! Primarily the medical tactic in placenta previa depends on

* fetal state

* gestational age

* +degree of bleeding

* type of placenta previa

* degree of cervical dilatation

! In the case of abruptio placentae the emergency cesarean section is performed under the following conditions of the fetus

* Breech position of fetus

* Viability of fetus

* Only when fetus is alive

* +Irrespectively of fetal state

* Only at threatened condition of the fetus

! The absolute indications for cesarean section is

* Uterine scarring

* Low placentation

* Breech presentation of fetus

* +Complete placenta previa

* Anatomical contracted pelvis first degree

! A pregnant woman with incomplete placenta previa at her 34 week of pregnancy scantly bleeds from genital tract. She was hospitalized. The future tactic is

* Amniotomy, labor stimulation

* Amniotomy, labor induction

* Planned Caesarean section

* Vaginally childbirth in full-term period

* +Bed rest, antispasmodic, hemostatic therapy

! The obstetric tactic in the case of abruptio placentae during the pregnancy is

* Amniotomy, labor stimulation

* Amniotomy, labor induction

* Planned Caesarean section

* +Emergency cesarean section

* Vaginally childbirth

! A pregnant woman with full-term gestation was diagnosed abruptio placentae, antenatal fetal death, hemorrhagic shock of I degree. The future tactics is

* labor induction by the oxytocin

* Amniotomy, labor induction

* Planned Caesarean section

* +Emergency cesarean section

* Observation before birth activity

! During surgery of caesarean section, done due to abruptio placentae it was detected that the uterus is of bluish-purple color, hypotonic and was diagnosed the Couvelaire uterus. The future tactics is

* Sanation and drainage of the abdominal cavity

* Total hysterectomy with appendages

* +Total hysterectomy without appendages

* Subtotal hysterectomy with appendages

* Subtotal hysterectomy without appendages

! During surgery of caesarean section, done due to abruptio placentae it was detected that the uterus is of bluish-purple color, atonic, which indicates the diagnosis of

* atony of uterus

* +couvelaire uterus

* placentaeaccretaecerae

* placentaeadhearens

* expansion of varicose veins of the uterus

! A pregnant at her 32 week of pregnancy with gestational hypertension complains to the acute pain in the lower abdomen, bleeding from the genital tract. Objectively, the uterus is tense, local tenderness, fetal heartbeat muffled, 170 heartbeats per minute. The most likely cause of bleeding is

* rupture of uterus

* cervical erosion

* placentaprevia

* expansion of varicose veins of the vagina

* +abruptio placentae