109 pregnancy Flashcards
any interruption of pregnancy before a fetus is viable
abortion
viable fetus
more than 20 to 24 weeks of gestation or one that weighs atleast 500 g
early miscarriage
before 16 week of pregnancy
late miscarriage
before 16 week and 24 week of pregnancy
developing placenta is tentatively attached to the decidua of the uterus
first 6 weeks of pregnancy
developing placenta is moderately attached
week 6 to 12
attachment is penetrating and deep
after 12 week
the stage of attachment that can lead to the most severe,even life threatening bleeding
between 6 and 13 week
most frequent cause of miscarriage in first trimester of pregnancy is
abnormal fetal development
due to teratogenic factor or chromosomal aberration
may be cause but ore strongly associated with pre term birth
urinary tract infection
systemic infections
rubella
syphilis
poliomyelitis
cytomegalovirus
toxoplasmosis
presenting symptoms of spontaneous miscarriage is almost always
vaginal spotting
symptoms of threatened abortion
vaginal bleeding( only scant/bright red)
slight crampling
no cervical dilation
key intervention in threatened abortion
avoidance of strenuous activity for 24 to 48 hours
the entire products of conception (fetus,membranes and placenta) are expelled spontaneously without any assistance
complete miscarriage
part of conceptus (usually fetus) is expelled,but the membranes or placenta are retained in uterus
Incomplete miscarriage
danger of maternal hemorrhage
Incomplete miscarriage
(D&C or suction curettage)
referred as early pregnancy failure,fetus dies in utero but is not expelled
missed miscarriage
usually discovered at prenatal examination when fundal height is measured and no increase in size
missed miscarriage
If the pregnancy is over 14 weeks in length and therefore these procedures are no longer possible, labor can be induced by a blank introduced into the cervix to cause dilation,
prostaglandin suppository or misoprostol (Cytotec)
missed miscarriage
followed by oxytocin stimulation or administration of
mifepristone (cause contractions and birth)
implantation occurred outside the uterine cavity
ectopic pregnancy
most common site of ectopic pregnancy
fallopian tube
80%- ampulla
12%- isthmus
8%- interstitial or fimbrial
implantation site
extrauterine
tubal
ovarian
abdominal
implantation site
intrauterine
cervical
comual
ectopic pregnancy appears to be increasing,possible because of
1.increase pelvic inflammatory disease (lead to tubal scarring)
2. vitro fertilization
3.Women who smoke
risk factor (ectopic pregnancy)
Previous PID (chlamydia infection)
Previous ectopic pregnancy
Tubal ligation
previous tubal surgery
intrauterine device
prolonged infertility
multiple sexual partners
also effective in diagnosing ectopic pregnancy
magnetic resonance imaging (MRI)
implantation was in the interstitial portion of the tube, rupture can cause
severe intraperitoneal bleeding
(because of the large vessels in the part of tube)
in ectopic pregnancy, woman usually experience
•sharp,stabbing pain in one of her lower abdominal quadrant
•shoulder tip pain
•scant vaginal spotting
severe shock as evidence by
rapid thread pulse
rapid respiration
falling blood pressure
leukocytosis ( from trauma)
falling Hcg
falling serum progesterone level
can also be used to visualize the fallopian tube
laparoscopy or culdoscopy
usually reveals a clear cut diagnosis picture (E.P)
ultrasonography
a woman waits for a time before seeking help, her abdomen gradually becomes rigid from peritoneal irritation. Her umbilicus may develop a bluish - tinged hue (Cullen Sign). She may have continuing extensive or dull vaginal and abdominal pain:raor novement of a cervix on pelvic examination can cause excruciating pain. She may fell pain in her shoulders as well from blood in the peritoneal cavity causing irritation to the phrenic nerve. A tender mass is usually palpable in Douglas cul-de-sac on vaginal examination.
• abdomen gradually becomes rigid from peritoneal irritation.
•umbilicus may develop a bluish - tinged hue (Cullen Sign).
• continuing extensive or dull vaginal and abdominal pain:
•pain in her shoulders
•tender mass is usually palpable in Douglas cul-de-sac on vaginal examination.
in ectopic pregnancy, it works by stopping the growth of the fertilized egg before a rupture occurs
methotrexate
therapy for ruptured ectopic pregnancy
laparoscopy
as with miscarriage, women with Rh-negative blood should receive
Rh (D) immune globulin (RHID/RoGAM)
for isoimmunization protection in future childbearing
abnormal proliferation and then degeneration of the trophoblastic villi
gestational trophoblastic disease (hydatidiform mole)
h-mole, as cells degenerate, they become filled with fluid
appear as clear fluid-filled
grape-sized vesicles
h-mole tend to occur most often in woman who have?
•low protein intake
•older than 35 years old
•asian heritage
•blood group A women marries group O men
two types of molar growth
complete mole
partial mole
