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5.

Explaining trimester bleeding in 1,2 and 3 (epidemiology, place,


etiology, risk factors, pathogenesis, principles, diagnosis,
comprehensive treatment, complications, and prognosis)

Graduation in a young pregnancy (trimester 1)


Occurs in pregnancy <20 weeks.
A. Abortus
Spontaneous spontaneous clearance before survival,
in pregnancy <20 weeks, jatropha beer <500 grams
Etiology:
Bleeding decidua basalis
Fetal factors: chromosomal abnormalities
Maternal factors: infection, chronic disease, malnutrition
Environmental factors: cigarettes, alcohol, etc.

Classification
Spontaneous abortion:
• Iminens: the abortion is financially aggravated but can
still whittle
• Insipient: complete, incomplete

Abortus provacatus (artificial)


• Artificial / therapeutic
• Crime
B. Mola hidatidosa
A pregnancy not found by the fetus and khorialis villi is
transformed into hydropic degeneration
Symptoms:
• High vomiting nausea
• Bleeding
• Often accompanied by lutein cysts
• Common with pre eclampsia and pulmonary emboli
Management
1. KU repair: blood transfusion
2. Air jar Mola :
• Vacuum curettage: done without anesthesia, done with a
blunt spoon
• Hysterectomy: old age of high parity is a predator of
malignancy
3. Examination: Hcg test should be normal 8 weeks after the
evacuation
C. ectopic pregnancy
The growth of a fertilized egg does not stick to the endoetrium
wall of the uterine cavity.

Etiology
1. tuba: inflammation / infection narrows and ciliary function twist and
the presence of tumor
2. abnormality of zygote: tumbh too fast
3. ovary: producing ova and captured by tuba.
4. hormonal: pill kb containing progesterone can help tubal movement
slows down
Pathology
1. The result of early conception and resorbed vascularization less and the
difficulty of total resorbsi.
2. Abortion into the lumen of the fallopian tube in the pregnancy of the
ampular pars
3. Tubular wall rupture

Symptoms
• Menstruation is delayed
• Lower abdominal pain bleeding
• Low Hb and high leukocyte
• The endometrium is thickened
Cavum uteri contains exudate
Vaginal bleeding
Bleeding in the 3rd trimester

1. Placenta Previa
The placenta implanted in the lower segment of the uterus
becomes full or part of the internal uterine os.

Klasifikasi :
• Placenta previa totalis: the false that covers the entire internal ostium
• Partial placenta previa: a partially enclosed parent ostium uteri
• Placenta previa marginalis: the edge of the placenta is on the edge of
the internal uterine os
Etiology
• Inflammation: Decidual vascularization
• Elderly and uterine defects
• Hypertrophic placenta hypoxemia smoker
• Placenta width and large cover ostium uteri internum
2. placental solutio
Displays part of the placental surface of the placenta from its implies

Klasifikasi :
• Mild placental sloutio: placenta loose <25%, blood coming out <250
ml
• Medium placenta solutio: loose placenta> 25%, blood out <1000 ml
• Severe placenta solutio: separate placenta> 50%, blood out 1000 ml

Pathophysiology:
• Diseases of the blood vessels burst in the blood vessels
• Hematoma rupture in the surrounding blood vessels
Etiology
• Never placenta solutio
• Premature rupture of membranes
• Preeclampsia
• Chronic hypertension
• Smoke

• Clinical features: bleeding and sickness, difficult fetal parts, anemia /


shock, strained uterus, djj reduced placenta concave