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Urogenital System > 8a. Bleeding In Early Pregnancy > Flashcards

8a. Bleeding In Early Pregnancy Flashcards

1
Q

What percentage of pregnancies experience early pregnancy bleeds

A

25%-30%

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2
Q

What percentage of early bleed pregnancies go on to abort spontaneously

A

50%

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3
Q

What are four Non pregnancy related causes of Early Pregnancy bleed

A

Cervicitis
Vaginitis
Vaginal lacerations
Cervical carcinoma

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4
Q

What are four pregnancy related causes of early pregnancy bleeds

A

Physiological bleeding
Spontaneous miscarriage
Ectopic Pregnancy
Molar Pregnancy

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5
Q

What are two causes of physiological bleeding of early pregnancy

A

Bleeding secondary to implantation

Relative deficiency in hormones (progesterone)

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6
Q

Physiological bleeding of early pregnancy is likely due to disruption of which vessels

A

Decidual vessels at the maternal-fetal interface

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7
Q

What are four Clinical Features of physiological bleeding of early pregnancy

A

Bleeding is usually minimal
Bleeding usually occurs within the first eight weeks of pregnancy
No associated pelvic pain
No cervical dilatation

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8
Q

Physiological bleeding of early pregnancy usually occurs within which weeks of pregnancy

A

First 8 weeks

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9
Q

List three steps in management of Physiological Bleeding of early pregnancy

A

Avoid Strenuous activity
Folic acid 5mg daily
Progesterone

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10
Q

What is the prognosis for Physiological Bleeding of early pregnancy

A

Usually good 90%-96%

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11
Q

What are the fetal risks for Physiological Bleeding of early pregnancy

A

Slight increased risk for low birthweight,
Premature labour
Neonatal mortality

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12
Q

Define Spontaneous Miscarriage

A

It is a natural termination of a pregnancy before the fetus is capable of extra uterine life (<24 weeks)

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13
Q

List five clinical stages of miscarriage

A 
Threatened miscarriage 
Inevitable miscarriage 
Incomplete miscarriage 
Complete miscarriage 
Delayed
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14
Q

Define Threatened Miscarriage (TM)

A

A pregnancy presenting with bleeding before 24weeks of gestation

(Cervical orifice closed)

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15
Q

A pregnancy presenting with bleeding before 24weeks of gestation

(Cervical orifice closed)

A

Threatened miscarriage TM

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16
Q

Define an Inevitable Miscarriage IM

A

It is considered inevitable when there is bleeding and the cervical os is open

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17
Q

What type of Miscarriage presents with a bleed and the cervical os is open

A

Inevitable miscarriage IM

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18
Q

Define an Incomplete Miscarriage

A

This is the passage of some but not all of the products of conception POC
from the uterine cavity through the cervical canal before 24weeks of gestation

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19
Q

What type of Miscarriage: This is the passage of some but not all of the products of conception POC
from the uterine cavity through the cervical canal before 24weeks of gestation

A

Incomplete Miscarriage

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20
Q

Define a complete miscarriage

A

This is characterized by the total expulsion of Products of conception and resolution of symptoms

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21
Q

What type of Miscarriage: This is characterized by the total expulsion of Products of conception and resolution of symptoms

A

Complete miscarriage

22
Q

Describe the Cervical os and Uterus in Complete Miscarriage

A

Cervical os is close

Empty uterus

23
Q

Define a delayed miscarriage DM/ missed abortion

A

Retention of a dead embryo

24
Q

Retention of a dead embryo

A

Delayed Miscarriage/ MissedAbortion

25
Define a blighted ovum
Failure or absence of an embryo at a very early stage of pregnancy- a sac/ placenta grows with no fetus
26
Failure or absence of an embryo at a very early stage of pregnancy
Blighted ovum
27
List six causes of Spontaneous Miscarriage
``` Chromosomal abnormalities Uterine or cervical factors Endocrine causes Immunological Disorders Teratogens and Infections Unknown ```
28
Give an example of a teratogen that can lead to Spontaneous Miscarriage
Mercury
29
Give an example of an infection that can lead to Spontaneous Miscarriage
Rubella
30
What percentage of spontaneous miscarriages are caused by chromosomal abnormalities
50%
31
What percentage of spontaneous miscarriages are caused by uterine or Cervical factors
5 to 10%
32
What percentage of spontaneous miscarriages are caused by Endocrine causes
20%
33
What percentage of spontaneous miscarriages have unknown origin
15%
34
List three types of chromosome abnormalities that can lead to spontaneous miscarriage
Autosomal trisomy Monosomy Triploids
35
Which chromosomal abnormality type most often causes spontaneous miscarriage
Autosomal trisomy | Trisomy 21, 18, 16
36
What causes Monosomy (45XO; turner)
Loss of paternal sex chromosome
37
Monosomy occurs in what percentage of Spontaneous Miscarriage
7%
38
Triploids occur in what percentage of Spontaneous Miscarriage
8-9%
39
What causes Triploids
It is the consequence of either dispermy or failure of extrusion of the second polar body
40
List three uterine abnormalities that can lead to Spontaneous Miscarriage
Septate uterus Fibroids (submucous) Polyp >2cm diameter
41
What are four Endocrine cause of Spontaneous Miscarriage
Poorly treated diabetes (type1/type2) Hypothyroidism and Hyperthyroidism Cushing Syndrome PCOS (Polycystic Ovarian Syndrome)
42
What are some clinical features of Spontaneous Miscarriage
Loss of pregnancy symptoms Vaginal bleeding Pelvic pain Passage of products of conception POC
43
Which tests are used to help predict or diagnose Spontaneous Miscarriage
Ultrasonography | With or without beta-hCG test
44
Expectant management of Spontaneous Miscarriage is indicated in patients when the ultrasound test shows what results
Ultrasound detects little tissue in the uterus with low or falling hCG
45
What is the medical management of Spontaneous Miscarriage
Misoprostal Or// Mifepristone (progesterone antagonist) and Misoprostal
46
Outline the Surgical management of Spontaneous Miscarriage
Evacuation of retained products of conception ERPC | (Currettage/suction)
47
List three steps in Post abortion care and counselling
Women advised to maintain Pelvic Rest ( nothing per vagina) until two weeks after evacuation Grief counseling Women who are Rh(D) -negative and unsensitized Should receive Rh(D) -immune globulin following surgical events
48
Why should Women who are Rh(D) -negative and unsensitized Should receive Rh(D) -immune globulin following surgical events
RHO (D) immune globulin is used to prevent antibodies from forming after a person or when a mother has RH negative blood and the baby is Rh positive blood
49
What is the risk of miscarriage in future pregnancy after one miscarriage ?
20%
50
What is the risk of miscarriage in future pregnancy after two miscarriages
30%
51
What is the risk of miscarriage in future pregnancy after three or more miscarriages
40-50%

Urogenital System (17 decks)

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