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Repro > Bleeding in early pregnancy > Flashcards

Bleeding in early pregnancy Flashcards

1
Q

What are some causes of bleeding in early pregnancy

A

miscarraige
ectopic pregnancy
hydatidiform mole
lower genital tract causes

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2
Q

What is a spontaneous miscarraige defined as?

A

expulsion of the products of conception prior to 24 weeks gestation

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3
Q

What is a threatened miscarraige?

A

no pain
cervix closed
minor bleeding
Fetal heart beat present

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4
Q

What is an incomplete miscarraige

A 
pain
heavy bleeding with clots
cervix open 
tenderness and shock
product of conception may be present in cervix
no Fetal heart beat
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5
Q

what is a complete miscarraige

A

like incomplete except cervix is closed
products of conception completely expelled
uterus is less than gestational age
no Fetal heart beat

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6
Q

What is a septic miscarraige

A

miscarraige associated with uterine infection

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7
Q

what are some causes of miscarraige relating to the conceptus

A

chromosomal - trisomy 16,22,21,15

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8
Q

What are some uterine causes of miscarraiage

A 
bicornate uterus
uterine septae
marked uterine ante / retroflexion
fibroids
incompetent cervix
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9
Q

What acquired diseases can cause miscarraige

A 
litsteria
malaria
influenza virus
hypertension
diabetes
thyroid disease
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10
Q

what investigations do you do for miscarriage

A 
haemoglobin, blood group and rhesus
beta - HCG preg test
ultrasound
serum HCG if you suspect hydatidiform mole
ECS and blood culture
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11
Q

How do you manage a threatened miscarraige

A

reassurance, rest
remove IUCD
aspirin, heparin, prednisolone

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12
Q

How do you manage an incomplete miscarriage

A

pain relief
blood transfusion if shocked
remove POC / allow uterus to evacuate self

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13
Q

What is an ectopic pregnancy

A

implantation of conceptus outside uterine cavity

can cause fatal intraperitoneal bleeding

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14
Q

What can cause ectopic pregnancy

A

chlamydia, gonococcal salpingitis
tubal surgery
endometriosis
IUCD

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15
Q

what are some symptoms of ectopic pregnancy

A 
pain, vaginal bleeding, amenorrhoea
shoulder tip pain
guarding
shock
syncope
cervical excitation
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16
Q

what investigations do you do for ectopic pregnancy

A

B HCG test
transvaginal US
laparoscopy

17
Q

what treatment do you give for ectopic pregnancy

A

salpingectomy / salpingotomy
IM methotrexate
intratubal methotrexate
laparotomy if ruptured

18
Q

describe molar pregnancy

A

non viable fertilised egg implants in uterus, grows as mass in uterus and is characterised by swollen chorionic villi.

is a gestational trophoblastic disease

characterised by presence of hydatidiform mole

mole = mass of growing tissue

19
Q

what are symptoms of molar pregnancy

A 
amenorrhoea
bleeding
uterus larger than dates
hyperemesis
pre eclampsia
20
Q

What investigations do you do for molar pregnancy

A

urine and serum HCG (will be raised)
US (will show snowstorm appearance)
CXR

21
Q

How do you treat a molar pregnancy

A

evacuation of uterus
contraception
hysterectomy

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