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Samenvatting hoofdstuk 17
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Hoofdstuk 17: bloedingen in de zwangerschap (cursus+ppt) + vergelijkende tabel abruptio & placenta previa
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Bloedingen in de zwangerschap (hs 17)1. TRIMESTER 1
Miskraam (50%)
EUG (meestal tubair) (cornuaal, cicatrieel,cervicaal gevaarlijker)
Trofoblastziekten
Andere (cervicitis, cervixpoliep/CA, ectropion, vaginaal trauma)
2. TRIMESTER 2 & 3
Placenta previa (maternale bloeding)
Abruptio/ Solutio placenta
Uterusruptuur
Wnr? = soms tijdens ZS maar meestal tijdens arbeid
= vnl litteken-uterus
(eerdere sectio/heelkunde, bindweefselziekten, ernstig trauma)
Sy? veel foëtale nood (kan heel snel gaan!!), pijn, bloeding, shock,…
Beleid? dringende laparotomie (foëtus in gevaar dringende sectio)
Vasa previa (foëtale bloeding)
Wat? = velamenteuze insertie NS en vaten insereren op vliezen
= vaten in ostium internum previa
Diagnose? echo >> navelstrenginsertie!!!!!! (je wil vasa previa NT missen!!)
indien velamenteus: vaginale echo
kan nog altijd gemist worden
Gevaar? - vnl bij breken bloeding
- foëtaal bloedverlies EXSANGUINATIE FOETUS (‘doodbloeden’)
hoge mortaliteit!
Beleid? dringende sectio
(indien vooraf geweten: primaire sectio 36w)
Placenta circumvallata
Andere (cervicitis, cervixpoliep/CA, ectropion, vaginaal trauma)
VASA PREVIA
PLACENTA CIRCUMVALLATA
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