Cuidado de la Mujer y el Recién Nacido

Hemorragia Del Segundo Trimestre Del Embarazo

Estudiantes:
Milena Benavides
Yohana Meza
Kevin Pantoja

Docente: Vilma Tamara Ortiz

 HEMORRAGIA DE SEGUNDO TRIMESTRE DEL
EMBARAZO

Sangrado que tiene lugar después de

las 22 semanas de gestación.
La causas:
Placenta Previa (PP)
Desprendimiento Prematuro De
Placenta (DPP)
Inserción anormal de la placenta
LA PLACENTA

Componentes

Fetales

Maternos

funciones
 TIPOS DE
PLACENTA

Anterior

Posterior

Fúndica

Placenta previa
CARA MATERNA DE LA
PLACENTA

Formada por el endometrio,

pegada al útero, presenta
cotiledones
CARA FETAL DE LA
PLACENTA

Proviene del
corión, presenta el
cordón umbilical, el
amnios y los vasos
coriónicos.
 ABRUPTIO PLACENTARIO
(DESPRENDIMIENTO PREMATURO DE
EMBARAZO)
Separación parcial o
total de la placenta
del fondo uterino

Existen dos formas

de desprendimiento
tanto la hemorragia
externa como interna
 causas
Antecedentes de cesaría
Miomas uterinos
Antecedentes de placenta previa:
Ruptura prematura de membranas:
Uterinas Defectos del útero
Endometritis
hipertonía

Reducción de oxígeno uteroplacentario

Embarazo gemelar
Eritroblastosis
Placentaria Condón umbilical corto
Polihidramnios

Traumatismos abdominales Diabetes mellitus

Hipertensión Preclamsia
Multiparidad Eclampsia
Maternas Edad menor a 20 y mayor a 35 Sobredistencion uterina
Tabaquismo efecto vasoconstrictor Endometritis
Cocaína
 GRADO: II GRADO: III GRADO: IV
GRADO: 0 no hay
hemorragia hemorragia hemorragia muy
síntomas
escasa moderada intensa

CLASIFICACION
 Dolor pélvico Contracciones Dolor espalda
uterinas frecuentes

SIGNOS Y
Sangrado
SINTOMAS Sufrimiento y muerte fetal
vaginal oscuro

Nauseas Vomito
Alteraciones
fetales
 Complicaciones
Coagulación intravascular
Encefalopatía
diseminada

Schock hipovolémico Hipoxia

Trastornos de Anemia
coagulación

Necrosis isquémica Prematuridad

Insuficiencia renal Muerte fetal

 Tratamiento

Transfusión Toma de
sanguínea signos vitales

Oxitocina
Control de
líquidos

Exámenes de laboratorio Administración de líquidos

 SEGÚN LA
SEVERIDAD
 Si el sangrado es escaso, sin
compromiso materno ni fetal :
 Metrorragia importante o
compromiso materno/ fetal:
 Metrorragia masiva, descompensación
hemodinámica materna(con edad
gestacional mayor a 25-26 semanas):
 La cesárea abdominal se
realiza:
 INSERCIÓN ANORMAL DE LA
PLACENTA

Las anomalías que se asocian a

graves complicaciones que causan
altas tasas de morbimortalidad
materna y perinatal.

Causas:

● Cesareas Previas.
● Antecedentes De Legrados.
● Miomectomía.
● Placenta previa.
● Edad de la madre.
 ACRETISMO
PLACENTARIO

Invasión anormal del trofoblasto

al miometrio.

Clasificación:
 Placenta Acreta
 Placenta Increta
 Placenta Percreta
• En la placenta accreta: Las vellosidades se insertan
directo en el miometrio

• Placenta increta: las vellosidades penetran en el interior

del miometrio.

• Placenta percreta: las vellosidades alcanzan la serosa

peritoneal e incluso penetran en la cavidad abdominal e
invaden órganos vecinos
Signos y sintomas
• Sangrado vaginal
durante el segundo o
tercer trimestre.

• Dolor tipo colico.

• Contracciones uterinas.

• En el parto la placenta
no puede
desprenderse dento de
los 30 minutos.
 Tratamiento

• Si se sospecha placenta
acreta, los médicos deben
considerar derivar a la
mujer a un centro con
experiencia en el manejo
de este trastorno (nivel
tres).
• Cesárea programada o
cesarea de urgencia con
histerectomía
• Transfusion sanguinea.

 
Artículos
 DESPRENDIMIENTO DE PLACENTA EN LA SEGUNDA FASE DEL PARTO: A
PROPOSITO DE UN CASO
Autora principal: Esther López Romero
Vol. XV; nº 15; 769

Abruptio placentae in the second stage of labour: case study

Fecha de recepción: 17/07/2020

Fecha de aceptación: 29/07/2020

Incluido en Revista Electrónica de PortalesMedicos.com Volumen XV. Número 15 –  Primera

quincena de Agosto de 2020 – Página inicial: Vol. XV; nº 15; 769

AUTORES: (López, E; Liza, P; Tébar ,D. al et)

Link:
https://www.revista-portalesmedicos.com/revista-medica/desprendimiento-de-place
nta-en-la-segunda-fase-del-parto-a-proposito-de-un-caso/
La placenta previa
La placenta previa es un
trastorno que se produce
durante el embarazo en el
que la placenta cubre total
o parcialmente la abertura
del útero
FACTORES DE RIESGO
 etiología
 Causas uterinas. cesáreas, legrados, multiparidad,
miomas, antecedentes de placenta previa, etc
 Causas placentarias. Como consecuencia de un
aumento exagerado del tamaño de la placenta
(gestaciones múltiples, riego sanguíneo bajo,
tabaquismo, consumo de cocaína, etc.).
tratamiento
En el tratamiento se debe
tener en cuenta el grado de
sangrado, la edad gestacional,
la vitalidad fetal, las patologías
asociadas y si existe o no
trabajo de parto.
SIGNOS Y SINTOMAS
El síntoma principal de la placenta
previa es un sangrado vaginal súbito.
Algunas mujeres también presentan
cólicos.
clasificación
Artículos
A picture is worth a
thousand words
Contraindications & indications

Mars Venus
● Describe the reasons to stop ● Describe the reasons to start
the treatment here the treatment here

● Describe the reasons to stop ● Describe the reasons to start

the treatment here the treatment here

● Describe the reasons to stop ● Describe the reasons to start

the treatment here the treatment here
Post-prevention

Venus has a beautiful name Mercury is the closest Despite being red, Mars is
and is the second planet planet to the Sun and the actually a very cold planet,
from the Sun smallest one full of iron oxide dust

Venus Mercury Mars

Case timeline
Day 2 Day 4
Jupiter is the biggest Earth is the only planet
planet of them all known to harbor life

Day 1 Day 3
Mercury is the smallest Despite being red, Mars
planet in the Solar System is actually a very cold
place
150,000
Big numbers catch your audience’s attention
9h 55m 23s
Jupiter's rotation period

333,000
The Sun’s mass compared to Earth’s

386,000 km
Distance between Earth and the Moon
More cases

Saturn Venus Mars Jupiter

Saturn is a gas giant Venus is the second Despite being red, It’s the biggest planet
and has several rings planet from the Sun Mars is a cold place in the Solar System
An image
reinforces the
concept
Images reveal large amounts of
data, so remember: use an image
instead of a long text. Your
audience will appreciate it
 Conclusions
Mercury is the closest planet to the Sun and
the smallest one in the Solar System—it’s only
a bit larger than the Moon. The planet’s name
has nothing to do with the liquid metal, since
Mercury was named after a Roman god
Our team

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