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Reproduction > Bleeding in Early Pregnancy > Flashcards

Bleeding in Early Pregnancy Flashcards

1
Q

When does the first trimester of pregnancy end?

A

13 weeks

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2
Q

When does the second trimester of pregnancy end?

A

28 weeks

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3
Q

How is gestation determined on USS?

A

head to bum ratio

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4
Q

Where does fertilisation ovvur?

A

fallopian tube

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5
Q

What is an ectopic pregnancy?

A

abnormal site of implantation

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6
Q

What is a molar pregnany?

A

abormal embryo

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7
Q

How common is bleeding in early pregnancy?

A

very common-20%

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8
Q

What are the causes of bleeding in early pregnancy?

A

miscarriage; ectopic; molar; implantation bleedings; chorionic haematoma; cervical and vaginal (infection; malignancy; polyp); haematuria; PR

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9
Q

What are the other common symptoms associated with bleeding in early pregnancy?

A

pain; hyperemesis; dizziness/fainting

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10
Q

What are the symptoms of miscarriage?

A

positive UPT; bleeding primary symptom >cramping

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11
Q

What is a threatened miscarriage?

A

os closed but there is a risk of pregnnacy

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12
Q

What is an inevitable miscarriage?

A

products are sited at open os

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13
Q

What is a complete miscarriage?

A

products are in the vagina

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14
Q

What are the causes of miscarriage?

A

embryonic abnormality; immunologic (APS); infection; environmental; severe emotional upsets; iatrogenic; associations with smoking, cocaine, alcohol misuse

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15
Q

What infections are implicated in miscarriage?

A

CMV; rubella; toxoplasmosis; listeria

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16
Q

What is a complete miscarriage?

A

all of pregnancy lost; uterus is empty

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17
Q

What is early fetal demise?

A

pregnancy-in-situ, no heartbeat. MSD>25mm; FP>7mm

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18
Q

What is MSD?

A

mean sac diameter

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19
Q

What is FP?

A

fetal pole

20
Q

What is the pathophysiology of miscarraige?

A

bleeding from placental bed or chorion causing hypoxia and villous/placental dysfunction

21
Q

What is recurrent miscarriage defined as?

A

3 or more pregnancy losses

22
Q

What are the causes of recurrent miscarriage?

A

antiphsopholipid syndrome; thrombophilia; balanced translocation

23
Q

What are the independent risk factors for recurrent miscarriage?

A

age and prevsious miscarriages

24
Q

Where is the most common site of ectopic pregnancy?

A

fallopian tubes

25
Q

What other areas are there ectopic pregnancy found?

A

ovary; peritoneum; other organs eg liver; cervix; CS scar

26
Q

What is the presentation of an ectopic pregnancy?

A

pain>bleeding; dizziness/collapse/shoulder tip pain; SOB

27
Q

What are the signs of ectopic pregnancy?

A

pallor; haemodynamic instability; signs of peritonism; guarding and tenderness

28
Q

What is seen onUSS with ectopic pregnancy?

A

empty uterus/pseudo sac +/- mass in adenexa; free fluid POD

29
Q

When should surgical management of ectopic pregnancy be considered?

A

acutely unwell

30
Q

What should medical mx of ectopic be considered?

A

women stable, low levels of bHCG and ectopic is small and unruptured

31
Q

What is seen with the plcenta in molar pregnancy?

A

overgrowth of placental tissue with chorionic villi swollen with fluid giving picture of grape-like clusters

32
Q

What drug is used in ectopic pregnancy?

A

methotrexate

33
Q

What is seen on USS with molar pregnancy?

A

snow-storm appearance

34
Q

What is the risk associated with complete mole?

A

risk of choriocarinoma

35
Q

What is a complete mole?

A

egg without DNA, 1 or 2 sperms fertilise resulting in diploidy

36
Q

What is a partial mole?

A

haploid egg with 1 sperm (reduplicating DNA) or 2 spems- triploidy, may have fetus

37
Q

What is the other name for a complete mole?

A

hydatiditoform mole

38
Q

What creates the snowstorm appearance on USS in complete mole?

A

multiple placental vesicles

39
Q

What is the management of molar pregnancy?

A

surgical and tissue for histology

40
Q

When does implanatation bleeding occur?

A

when fertilised egg implants into the uterine wall about 10 days post-ovulation

41
Q

How does implantation bleeding appear?q

A

light/brownish and limited

42
Q

What is a chorionic haematoma?

A

pooling of blook between endometrium and embryo due to separation

43
Q

What are the symptoms of chorionic haematoma?

A

bleeding, cramping and threatened miscarriage

44
Q

What is the prognosis of chorionic haematoma?

A

usually self-limiting and resolve, larg can cause infection, irritability and miscarriage

45
Q

What are the cervical causes of bleeding in early pregnancy?

A

ectopy/ectropion; infections; polyp; malignancy

46
Q

What are the vaginal causes of early bleeding in pregnanyc?

A

infections (trichomoniasis; BV; chlamydia); malignancy; forgotten tampon

Reproduction (52 decks)

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