Such digital cervical examination is never permissible unless the woman is in an operating room with all the preparations for immediate cesarean delivery—even the gentlest digital examination can cause torrential hemorrhage.
Ultrasound can not only diagnose placenta previa, but further define it as complete, partial, or marginal, which can have implication in how to manage the patient.
Furthermore, as part of management, Ob case analysis superstar intravenous access and baseline laboratory studies hemoglobin, hematocrit, platelet count, blood type and screen, and coagulation studies should be obtained.
In contrast, placental abruption, classically presents with painful vaginal bleeding. They challenge your managerial insight and ability to apply what you are learning. All members of your team must participate in the presentation. Then read it more carefully. Women with a previa may be considered in one of the following categories: To practice thinking like a manager.
It was also felt that her fetus was reasonably mature, and the decision was made to do an emergency cesarean section. Our patient had several, including increased parity, increased maternal age, and residence in higher altitude.
Prepping the patient before surgery. Write your answer to these questions in the first person, and support each of your major points with the appropriate OB theory. Placenta previa is defined as the presence of placental tissue over or adjacent to the cervical os, and can be described within a variety of possibilities: These questions challenge you to apply your OB learning to a practical situation.
Present yourself as a manager when giving your analysis. To provide an opportunity for you to apply your new management knowledge.
Because of the risk of provoking life-threatening hemorrhage, a digital examination is absolutely contraindicated until placenta previa is excluded. Below is a list of several risk factors that are associated with placenta previa. Seek questions and comments from the class 7.
In a case analysis you must combine the facts and your insights and inferences that you gain from studying the case together with the appropriate Organizational Behaviour theories to develop a credible explanation of what is at the heart of the events in the case and what should be done to make things better.
List of associated risk factors for placenta previa. Many cases of placenta previa that are diagnosed in the second trimester will resolve by the third trimester. A cervical examination was deferred in our patient, as appropriate management.
Although our patient was clinically stable, her bleeding could not be appropriately controlled. Compare with the 2 textbook images shown below.
Some pictures below show the cesarean operation of our patient, and the delivery of a healthy baby: The fetus is preterm and there are no other indications for delivery The fetus is reasonably mature Labor has ensued Hemorrhage is so severe as to mandate delivery despite gestational age.
Your case analysis should be written as if you are writing a report to give to your manager at work. Classically, the clinical presentation of placenta previa is painless vaginal bleeding in the second or third trimester. Total occlusion of internal cervical os Discussion: Read the question you are answering to the class slowly and clearly c.
Total placenta previa—the internal os is covered completely by placenta Partial placenta previa—the internal os is partially covered by placenta Marginal placenta previa—the edge of the placenta is at the margin of the internal os Low-lying placenta—the placenta is implanted in the lower uterine segment such that the placental edge does not reach the internal os, but is in close proximity to it Vasa previa—the fetal vessels course through membranes and present at the cervical os Diagram showing different categorizations of placenta previa.
I do not want that to happen to you and I am certain that you do not want that to happen as well, so please read the following instructions carefully: To develop your analytical skills 4. Each of the case questions will be presented by a different team member.Oct 08, · This feature is not available right now.
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Case Study: Diagnosis of Dandy-Walker Malformation. Joe Antony, MD; Mar 13, These images of a fetal brain from a routine ultrasound examination at 22 weeks' gestation revealed a rare congenital brain abnormality.
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He competes with everyone else in his profession, including himself to redefine the excellence level. Case Study Guidelines Course Grading & Evaluation News & Links. OB HOME PAGE WEBSITE HOME PAGE. Print “OBT” in the right margin to indicate where you have used OB Theory to support your work.
YOUR CASE ANALYSIS MUST BE HANDED TO ME NO LATER THAN ONE WEEK AFTER YOUR PRESENTATION TO THE CLASS.
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