Bleeding in Early Pregnancy Flashcards
To how many weeks is a foetus usually carried?
40 weeks
When is trimester 1 completed?
13 weeks
When is trimester 2 completed?
28 weeks
When is trimester 3 completed?
40 weeks
What is gestation estimated by?
Dates + USS
When is there a focus on bleeding?
1st trimester
What is the marker of pregnancy?
hbCG
What is the sensitivity of the urine pregnancy test like?
High – can detect pregnancy as early as 20IU
Where does fertilisation occur?
In the fallopian tube
Where does implantation occur?
In the uterine cavity
What migrates to the uterine cavity?
Blastocyst
What can ‘house’ the pregnancy?
Uterine wall
List the 3 potential abnormal pregnancy outcomes.
Miscarriage – normal embryo.
Ectopic pregnancy – abnormal site of implantation.
Molar pregnancy – abnormal embryo.
What % of women experience bleeding in early pregnancy?
20%
Aside from miscarriage, give examples of other causes of bleeding in early pregnancy.
- Implantation bleeding.
- Chronic haematoma.
- Cervical causes
- Vaginal causes
- Unreleated e.g haematuria
List some cervical causes of bleeding in early pregnancy.
- Infection
- Malignancy
- Polyp
List some vaginal causes of bleeding in early pregnancy.
- Infection
* Malignancy
Outline the key features of a miscarriage.
- Positive UPT.
- Varied gestation.
- Bleeding is primary symptom (> cramping).
- ‘Period cramps.’
- Passed products may be brought in.
What will a scan of someone having a miscarriage show?
A pregnancy in situ (+/- FH), in the process of expulsion or an empty uterus.
What is a speculum exam used for during investigations of someone with a miscarriage?
To confirm if:
- the os is closed (threatened).
- products are sited at open os (inevitable).
- or in vagina (complete).
What is the most common contributing factor to a lady having a miscarriage?
Chromosomal abnormality
What causes embryological demise?
Bleeding from placental bed or chorion causing hypoxia and villous/placental dysfunction.
Outline the 5 different categories of miscarriage.
1 – Threatened Miscarriage.
- risk to pregnancy due to bleeding and cramping, but pregnancy is still in situ.
2 – Inevitable Miscarriage.
- pregnancy can’t be saved.
3 – Incomplete Miscarriage.
- part of pregnancy lost already.
4 – Complete Miscarriage.
- all of pregnancy lost, uterus is empty.
5 – Early Foetal Demise.
What is meant by ‘early foetal demise’?
Pregnancy in-situ, but no heartbeat: MSD >25mm, FP >7mm