Bleeding in Early Pregnancy

Question 1

Miscarriage is defined as loss of a pregnancy before how many weeks gestation?

Answer 1

24wks

Question 2

If “products” can be visualised in an open OS, the miscarriage is described as what?

Answer 2

Inevitable

Question 3

Is bleeding up to 12wks gestation always worrying?

Answer 3

No; partial shedding of the decidua at the time of a missed period can occur up to 12wks gestation.

Question 4

What is the main difference between threatened and inevitable miscarriage?

Answer 4

In inevitable; uterine contractions have started to dilate the cervix.
In threatened; no dilation occurs and it is typically painless.

Question 5

What is “doughnut sign” in relation to ectopic pregnancy?

Answer 5

Presence of heterogenous adnexal mass separate from 2 clearly identified ovaries on TVUS.

Question 6

What is “ring of fire” in relation to ectopic pregnancy?

Answer 6

Increased blood flow to ectopic gestation seen on colour Doppler.

Question 7

In ectopic pregnancy, what is the effect on serial blood hCG?

Answer 7

Steady decrease; or failure to increase as expected.

Question 8

What is the difference between salpingotomy and salpingectomy?

Answer 8

Salpingotomy - removal of both Fallopian tubes.

Salpingectomy - removal of the tube involved only.

Question 9

Give 2 reasons for excessive pregnancy symptoms

Answer 9

Hydatiform moles and multiple pregnancy

Question 10

In hydatiform moles, what is the classic USS sign?

Answer 10

Snow-storm appearance