1st Trimester Complications

Question 1

what is the function of hCG and when does it peak during pregnancy?

Answer 1

promotes maintenance of the progesterone-secreting corpus luteum; peaks at 10 weeks gestation at about 100,000 mIU/mL

Question 2

what are the implications for hCG’s similarity with LH?

Answer 2

hCG it can be used to induce ovulation in the female ovary during fertility treatment as well as stimulate testosterone production in the male testes

Question 3

mechanism of urine pregnancy test

Answer 3

employs monoclonal antibody specific to the beta subunit of hCG

Question 4

what is the rate of increase of serum hCG during a normal pregnancy?

Answer 4

doubles every 48 hours

Question 5

what is the discriminatory zone of hCG?

Answer 5

1500-2000 mIU/mL, when transvaginal ultrasound should be able to visualize the pregnancy

Question 6

difference between inevitable and incomplete abortion

Answer 6

inevitable abortion is without passage of products of conception, whereas incomplete is partial passage of products of conception

Question 7

what is a missed abortion?

Answer 7

intrauterine demise < 20 weeks without any passage of fetal or placental tissue

Question 8

treatment for ectopic pregnancy

Answer 8

surgery or methotrexate

Question 9

dx: extremely high hCG, snowstorm appearance on ultrasound

Answer 9

complete molar pregnancy

Question 10

complete molar pregnancy: _____ proliferation, results from _____, paternally-derived _____ genotype

Answer 10

trophoblastic; fertilization of an enucleate egg; diploid

Question 11

partial molar pregnancy: contains ____, arises from _____

Answer 11

fetal tissue; fertilization of a haploid ovum by two sperm or by a single sperm that then duplicates

Question 12

complete moles: __ sets of genes (__ maternal, __ paternal), __ fetus
partial mole: __ sets of genes (__ maternal, __ paternal), __ fetus

Answer 12

complete: 2 (diploid); 0; 2; no

partial mole: 3 (triploid); 1; 2; non-viable

Question 13

treatment for hyatidiform molar pregnancy and choriocarcinoma and its mechanism of action

Answer 13

methotrexate; binds to dihydrofolate reductase and interfere with DNA synthesis

Question 14

dx: hCG fails to increase by at least 53% over 48 hours

Answer 14

ectopic pregnancy

Question 15

dx: 43 year old female with heavy vaginal bleeding, urine pregnancy test is positive, ultrasound shows embryo without cardiac activity, cervix is open

Answer 15

inevitable abortion