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repro > bleeding in early pregnancy > Flashcards

bleeding in early pregnancy Flashcards

1
Q

what is the most common cause of bleeding in early pregnancy?

A

spontaneous miscarriage

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2
Q

pain -ve, bleeding not profuse, cervix closed. uterus = gestational age

A

threatened miscarriage

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3
Q

family history in threatened miscarriage?

A

positive

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4
Q

inevitable miscarriage is similar to ?

A

incomplete miscarriage.

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5
Q

what is different about inevitable and incomplete?

A

inevitable hass a positive family history

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6
Q

cervix in threatened miscarriage?

A

closed

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7
Q

cervix in an incomplete miscarriage? what may be seen?

A

open, products of conception may be seen.

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8
Q

lower abdominal pain, HEAVY bleeding (with clots and tissues), shock +ve, tenderness +ve, POC may be present in cervix

A

y

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9
Q

what is septic miscarriage?

A

infection following a miscarriage

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10
Q

family history in incomplete miscarriage?

A

-ve

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11
Q

bleeding in complete miscarriage?

A

cessation of bleeding

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12
Q

what is the size of the funds like?

A

smaller than gestational age

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13
Q

complete miscarriage, small abdomen, cervix closed, no bleeding

A

fh -ve

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14
Q

why would you do haemoglobin?

A

anaemia

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15
Q

what other investigations would you do?

A

blood group and Rh typing, B hCH pregnancy test

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16
Q

why do you do b hcg?

A

if a hyatidiform mole is suspected

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17
Q

if sepsis is present while pregnant, what is done?

A

elective cesarian section and blood culture

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18
Q

treatment of a threatened miscarriage?

A

reassure, rest, avoid sex

19
Q

when would you give aspirin, heparin or prednisolone for APLS?

A

after the first trimester

20
Q

inevitable miscarriage management?

A

allow uterus to evacuate itself. PAIN RELIEF, OXYTOLIC, evacuation of uterus

21
Q

for an incomplete miscarriage, what do you do for shock?

A

blood transfusion. remove POC. bimanual compression of the uterus

22
Q

septic miscarriage treatment?

A

evacuate, resucitate, shock management

23
Q

if had 3 miscarriages, probability of live birth in next pregnancy will be 40-50 percent.

A

investigations such as karyotyping, GTT, t4 or tsh can be done.

24
Q

does ectopic pregnancy cause bleeding?

A

yes

25
Q

amenorrhoea - why?

A

patient is pregnant, corpus luteum maintaining pregnancy

26
Q

where can you get referred pain to in ectopic pregnancy?

A

shoulder tip

27
Q

woman, no period 2 months, lower abdominal pain, adenexal tenderness, CERVICAL EXCITATION (tenderness)
abdominal guarding, bulky uterus, shock and syncope (ruptured)

A

ectopic pregnancy

28
Q

outcomes?

A

tubal abortion/tubal rupture

29
Q

how do you investigate?

A

pregnancy test, serum bhcg, transvaginal US scan, diagnostic laparotomy

30
Q

what is the treatment?

A

salpingectomy, IM methotrexate, conservative management

31
Q

what do you do if its ruptured?

A

laparotomy

32
Q

development anomaly of the trophoblast or placenta in which there is a local or general vesicular change in the chorionic villi?

A

hydatidiform mole

33
Q

what appearance does it have on US?

A

snowstorm appearance

34
Q

what does the uterus feel like?

A

doughy

35
Q

name of the ovarian cysts?

A

theca lutein

36
Q

why do you get weight loss and dehydration?

A

persistent vomiting (hyperemesis)

37
Q

uterus larger than dates, doughy, amenorrhoea, persistent vomiting, vaginal bleeding

A

hydatidiform mole. increased pre eclampsia

38
Q

what would you see on ultrasound?

A

snowstorm appearance and theca lutein ovarian cysts

39
Q

there is a possibility of malignant change to choriocarcinoma. whats the treament?

A

evacuation of uterus, prolonged follow up, ***CONTRACEPTION to avoid pregnancy during follow up. hysterectomy if no desire for further childbearing. persistent disease requires chemotherapy.

40
Q

Investigations?

A

urinary and b hcg levels

41
Q

cervical cerclage, what is this? when is it usually down and when taken out?

A

stitches in the cervix. done at 14 weeks and removed at 36 weeks

42
Q

cervix begins to dilate before pregnancy has reached term?

A

cervical incompitence. NO PAIN IN CERVICAL DILATION

43
Q

what is the purpose of giving methotrexate in an ectopic pregnancy?

A

stops the growth of the fetus, can be done if surgery can’t be performed immediately

repro (30 decks)

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