Abnormal and Interrupted Fetal Development

Question 0

A Fallopian tube pregnancy is considered a what pregnancy?

Answer 0

Non viable

Question 1

Implantation of a fetus other than the endometrium such as Fallopian tubes, fundus, and endometrium

Answer 1

Ectopic pregnancy

Question 2

The incidence of an ectopic pregnancy increases due to what two main things?

Answer 2

Scarring

Assisted reproduction

Question 3

Endometriosis (1st), previous ectopic (10%), progesterone (slows motility of the egg), assisted reproduction,tubal abnormality, adhesions from surgery, PID, and sterilization (but sperm reaches it) are all what?

Answer 3

Risk factors of ectopic pregnancy

Question 4

What are the symptoms of ectopic pregnancy?

Answer 4

Nausea
Vomiting
Breast tenderness
Missed period

Question 5

Prior to rupture what symptoms might be present to an ectopic pregnancy?

Answer 5

Pelvic pain
Back pain
Scant bleeding

Question 6

Signs of acute severe pain, referred shoulder pain (blood irritates phrenic nerve), and signs of shock (decreased blood pressure, increased heart rate, pale, and dizziness might indicate what?

Answer 6

Ruptured ectopic pregnancy

Question 7

What are the two treatments for an ectopic pregnancy?

Answer 7

Laparoscopy (remove fertilized ovum)

Methotrexate (destroys pregnancy)

Question 8

What is the clear definitive diagnostic study for an ectopic pregnancy?

Answer 8

Ultrasound that shows empty uterus but Hcg levels still increasing.

Question 9

A pathological proliferation of trophoblastic cells (placenta)

Answer 9

GTD (gestational trophoblastic disease)

Question 10

What are the two diseases associated with GTD?

Answer 10

Hydatiform Mole

Choriocarcinoma

Question 11

What is a tell tale sign of hydatiform mole or molar pregnancy? This is a non viable pregnancy.

Answer 11

Uterus grows abnormally fast

Question 12

These vesicles pull fluid from maternal vesicles

Answer 12

Hydropic vesicles

Question 13

What is the cause?

Answer 13

Unknown

Question 14

Under 15 or over 45, previous molar, Asian or Latin American, 1/1000 pregnancies are all what?

Answer 14

Risk factors for a molar pregnancy

Question 15

What are the two types of molar pregnancy?

Answer 15

Complete

Partial

Question 16

This type has only paternal chromosomes (46). The sperm fertilizes an empty egg and divides. No embryo or fetal tissue. No chromosomes.

Answer 16

Complete

Question 17

This type has a normal ovum but is fertilized by two sperm or abnormal sperm and contains 69 chromosomes. There is fetal tissue because of the maternal chromosomes but this tissue is malformed.

Answer 17

Partial

Question 18

What 5 findings are indicative of a molar pregnancy?

Answer 18

Vaginal bleeding that is brown/prune juice and always happens)
Anemia (because of bleeding)
Enlarged uterus
No FHT (fetal heart tone)
Early PIH (pregnancy induced hypertension)

Question 19

How is a molar pregnancy diagnosed?

Answer 19

Hcg severely elevated
Severe N/V (hyperemesis gravidarum)
Ultrasound

Question 20

Treatment for a molar pregnancy?

Answer 20

Remove

Question 21

What can a molar pregnancy lead to?

Answer 21

Choriocarcinoma

Question 22

Cancer arose in placenta during pregnancy?

Answer 22

Choriocarcinoma

Question 23

What is the percentage of this happening after a molar pregnancy?

Answer 23

20%

Question 24

What medication is very effective for choriocarcinoma?

Answer 24

Methotrexate

Question 25

What percentage is the cure if it is in the uterus?

Answer 25

100%

Question 26

Methotrexate is used for choriocarcinoma until what is negative?

Answer 26

Hcg (trophoblastic cells are gone)

Question 27

Any interrupted development of the fetus is considered what?

Answer 27

A threatened or imminent abortion

Question 28

Termination of pregnancy before viability is called?

Answer 28

Abortion

Question 29

Medical termination of a pregnancy is called a what?

Answer 29

Induced abortion

Question 30

A woman's request to end a pregnancy is called what?

Answer 30

Elective abortion

Question 31

An end to a pregnancy that results from a maternal medical condition or fetal anomalies is called what?

Answer 31

Therapeutic abortion

Question 32

A pregnancy ending in miscarriage is called what?

Answer 32

Spontaneous abortion

Question 33

What is the percentage for spontaneous abortions?

Answer 33

80%

Question 34

Maternal illness and and weak cervix usually cause a spontaneous abortion at how many weeks?

Answer 34

12-20 weeks

Question 35

Fetal genetic abnormalities account for what percentage of cases?

Answer 35

50%

Question 36

Days of unexplained bleeding or cramping, the cervix remains closed, nothing is expelled, and it carries a risk for expulsion.

Answer 36

Threatened abortion

Question 37

How to we treat a threatened abortion?

Answer 37

Limit activity Avoid stress, fatigue, and sex Be honest to the mom

Question 38

A termination in progress associated with bleeding or cramping, and cervix dilates. This is when the placenta is separating.

Answer 38

Imminent abortion

Question 39

How do we treat an imminent abortion?

Answer 39

Monitor Ultrasound D/C

Question 40

Partial retained pregnancy which can contain the fetus but may be the placenta. It presents as bleeding with fragments.

Answer 40

Incomplete abortion

Question 41

How do we treat an incomplete abortion to expel contents?

Answer 41

D/C Pitocin Methergine

Question 42

A pregnancy that ends with products expelled completely and presents as menses delayed but produce a heavy flow.

Answer 42

Complete abortion

Question 43

A pregnancy where fetus does in utero but is not expelled and cervix remains closed. Fetal autolysis - tissue breakdown.

Answer 43

Missed abortion

Question 44

How do we treat a missed abortion?

Answer 44

Remove fetus and tissue

Question 45

Consecutive abortions

Answer 45

Recurrent pregnancy loss

Question 46

Consecutive abortions are caused by 3 different things

Answer 46

Anatomical (weak cervix/incompetent cervix) Hormonal (40% of the time) Genetic

Question 47

Sewing of the uterus or cervix

Answer 47

Cerclage

Question 48

Presence of infection from an dead fetus. Due to rupture of membranes that leave an open tract for germs. Treated by antibiotics and removal of fetus.

Answer 48

Septic abortion

Question 49

Ovum development stops in the first trimester. Presents as an absence of properly developed and recognizable fetal parts and no fetal heart.

Answer 49

Blighted ovum

Question 50

An elective abortion can be obtained when?

Answer 50

Up to 12 weeks

Question 51

The state regulates elective abortions when?

Answer 51

12-20 weeks

Question 52

When is an elective abortion prohibited?

Answer 52

Over 20 weeks (unless to save the moms life)

Question 53

Two types of elective abortion?

Answer 53

Medical | Surgical

Question 54

What are the three types of medications given for elective abortion?

Answer 54

RU 486 (mifepristone) with misoprostol Methotrexate Misopristol (cytotec)

Question 55

When can a medical abortion be obtained?

Answer 55

Up to 7 weeks and works 96% of the time

Question 56

The cervix is anesthetized with local anesthesia, the cervical os is dilated, a suction cannula is presented, and mechanical scraping of the uterus. It's safer and preferred method.

Answer 56

Surgical abortion

Question 57

What procedure is performed for an elective abortion greater than 12 weeks and less than 20 weeks.

Answer 57

D/E