Abnormal 1st trimester Flashcards
termination of a pregnancy prior to 20 weeks
Abortion
- Evacuation of ALL products of conception
* Cramping, Bleeding w/ clots, and decreased hCG levels.
Complete abortion
- Partial evacuation of products of conception
- Slow fall or plateau of hCG
- Cramps and heavy bleeding
Incomplete Abortion
- Presence of embryo within UT with no cardiac activity
- M/C in second trimester
- hCG levels low for dates
- Decrease UT size, Vaginal discharge
Missed Abortion
- Condition in which the future of the pregnancy may be in jeopardy
- Closed cervix, bleeding or cramping
Threatened abortion
• 2 or more of the following signs are noted: o Moderate effacement of CX o Dilation of CX >3cm o Rupture of membranes o Cramping, bleeding >7days
Invisible abortion
• No embryo seen within GS of 25mm or larger
Anembryonic Pregnancy (Blighted Ovum)
Implantation of conceptus outside of the endometrium. M/C in ampullary of fallopian tube
Ectopic pregnancy
o Empty UT w/ TV sono when hCG levels are between 800 & 1000
o Presence of adnexal Mass w/ possible ring of fire
o free fluid in CDS, adnexa or Morrison’s pouch
o Presence of an endometrial decidual reaction
o ***PITFALL- FLUID in endo= no ectopic
• Corpus Luteum cyst- mimics ring of fire
** give drug METHOTREXATE to dissolve ectopic
Indication for ectopic pregnancy
concomitant intra and extrauterine pregnancies. M/C in the fertility patients
• Abnormal Clinical Findings:
o Abnormal rise of serum hCG levels
o Leukocytosis or slight fever
o Pain referred to shoulder caused by intraperitoneal hemorrhage
Hetertopic pregnancy
- Results from excessive proliferation of trophoblastic tissue.
- ↑ AFP ↑↑hCG
- can cause hypertension in 1st trimester & large GA
- Assoc. w/ THECA LUTEIN CYSTS
(Classifications 4)
Gestation Trophoblastic Disease
4 classifications
• M/C form of GTD • No fetal tissue or embryo identified • Risk Factors: o Women <20 or >40 w/ poor diets • Sono: endo w/ echogenic, homogenous material and multiple cystic spaces. Ovarian theca lutein cysts. Hypervascular low resistance
Complete Hydatitiform Mole
o 1 egg with 2 sperms= 3 sets of chromosomes resulting in a triploid karyotype
o Not compatible with life
o Deformed GS with growth restricted fetus
Partial mole
o 2 conceptions. One normal and one GTD
o Sono: fetus usually normal w/ placenta and membranes
Mole with Co-existing normal fetus (RARE)
PTN)-Complication of pregnancy that can follow a GTD, SAB, Ectopic or normal term delivery
o Invasive Mole AKA Chorioadenoma Destruens
▪ M/C form of PTN.
▪ RECURRENT mole penetrates myometrium and possibly uterine wall.
▪ MALIGNANT- NON Metastatic
o Choriocarcinoma (RARE)
▪ Vascular invasion, hemorrhage and necrosis of the myometrium.
▪ MALIGNANT- can metastasize to lung, brain, liver, bone, GI and skin
▪ Elevated hCG in a NON- pregnant patient
Persisent Trophoblastic Neoplasia
