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Repro > Bleeding in Early Pregnancy > Flashcards

Bleeding in Early Pregnancy Flashcards

1
Q

How long in general is a fetus carried for?

A

40 weeks

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2
Q

When does the 1st trimester end?

A

@ 13 weeks

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3
Q

When does the 2nd trimester end?

A

@ 28 weeks

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4
Q

When does the 3rd trimester end?

A

@ 40 weeks

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5
Q

How is gestation decided?

A

By ultrasound scan

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6
Q

What is the marker for pregnancy?

A

beta-HCG

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7
Q

Where does fertilisation usually occur?

A

Fallopian tube

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8
Q

Where does implantation usually occur?

A

Uterine cavity

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9
Q

What travels from the fallopian tube to the uterine cavity?

A

Morula/Blastocyst

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10
Q

What are possible abnormal pregnancy outcomes?

A 
Miscarriage (normal embryo)
Ectopic pregnancy (abnormal site of implantation)
Molar pregnancy (abnormal embryo)
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11
Q

How common a problem is bleeding in early pregnancy?

A

20%

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12
Q

What are cervical causes of bleeding?

A

Infection
Malignancy
Polyp

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13
Q

What are vaginal causes of bleeding?

A

Infection

Malignancy (rare)

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14
Q

What are other causes of bleeding in early pregnancy?

A

Implantation bleeding
Chorionic haematoma
Haematuria
PR bleeding

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15
Q

What are the dedicated sub departments for bleeding in early pregnancy?

A

EPAC/EPAU

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16
Q

What symptoms often accompany the bleeding?

A

Pain (cramps)
Hyperemesis
Dizzyness/fainting

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17
Q

What are symptoms of a miscarriage?

A

+ve UPT
Varied gestation
Bleeding and cramping

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18
Q

How do you diagnose a miscarriage?

A

A scan will help confirm a pregnancy in situ +/- FH, in process of expulsion or an empty uterus

19
Q

How can you confirm if the uterus is closed?

A

Via speculum exam

20
Q

What is a risk to the pregnancy called?

A

A threatened miscarriage

21
Q

what is a pregnancy that can’t be saved called?

A

Inevitable miscarriage

22
Q

What is it called when part of a pregnancy is lost?

A

Incomplete miscarriage

23
Q

What is it called when all of the pregnancy is lost and the uterus is empty?

A

Complete miscarriage

24
Q

What is Early Fetal Demise?

A

Pregnancy is situ, no heartbeat, MSD >25mm , FP > 7mm

25
Q

Where is a common site for an ectopic pregnancy?

A

Fallopian tube

26
Q

Where are other sites of an ectopic pregnancy?

A 
Ovary
peritoneum
liver
cervix
CS scar
27
Q

What is the presentation of an ectopic pregnancy?

A

Pain, bleeding, dizziness, collapse, shoulder tip pain, short of breath

28
Q

What findings are found with someone with an ectopic pregnancy?

A

Pallor, hemodynamic instability, signs of peritonism, guarding and tenderness

29
Q

What are investigations for someone with an ectopic pregnancy?

A

FBC, G&S,beta-HCG, USS

30
Q

What will an USS show with an ectopic pregnancy?

A

Empty uterus/pseudosac +/- mass in adenexa, free fluid POD

31
Q

What is a molar pregnancy?

A

Gestational trophoblastic disease
Nonviable fertilised egg
Overgrowth of placental tissue with chorionic villi swollen with fluid giving picture of ‘grape like clusters’

32
Q

What risk does a complete mole have of becoming a choriocarcinoma?

A

2.5%

33
Q

What is a complete mole?

A

Egg without DNA
1 or 2 sperms fertilise, result in diploidy (paternal contribution only)
No fetus
Overgrowth of placental tissue

34
Q

What is a partial mole?

A

Haploid egg
1 sperm (reduplicating DNA material) or 2 sperms fertilising egg, resulting in triploidy
May have fetus
Overgrowth of placental tissue

35
Q

How does a molar pregnancy present?

A 
Hyperemesis
Varied bleeding and passage of g'rapelike tissue'
Fundus> dates
Occasional SOB
USS can diagnose "snow storm appearence"
36
Q

What is the management of a molar pregnancy?

A

Surgical and tissue for histology

Follow up with Molar Pregnancy Services

37
Q

What is implantation bleeding?

A

Fertilised egg when implants into the uterine wall around 10 days post ovulation, bleeding is light/brownish and limited
signs of pregnancy soon emerge
Often mistake as period but its heavier

38
Q

What is a chronic haematoma?

A

Pooling of blood between endometrium and the embryo due to separation - subchorionic

39
Q

What happens with a chronic haematoma?

A

Bleeding, cramping, threatened miscarriage

40
Q

What may arise from a chronic haematoma?

A

Infection, irratability

miscarriage

41
Q

How do you manage a chronic haematoma?

A

Reassurance and surveillance

42
Q

Can a forgotten tampon cause bleeding?

A

Yes

43
Q

What else can cause vaginal bleeding?

A 
Ulcers
Malignancy
Trichomoniasis (strawberry vagina)
bacterial vaginosis
chlamydia
44
Q

What unrelated bleeding can occur?

A

Urinary infection with haematoma

Bowel - haemarroids and malignancy

Repro (46 decks)

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