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OB GYN REGISTRY > Ch. 10 Abnormal First Trimester > Flashcards

Ch. 10 Abnormal First Trimester Flashcards

1
Q

Abortion is the termination of pregnancy prior to —- weeks of gestation

A

20

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2
Q

Spontaneous AB usually occurs – to – weeks after embryonic or fetal demise

A

1-3

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3
Q

Term for when all products of conception are expelled

A

complete abortion

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4
Q

sono finds of a complete AB

A

empty uterus with normal endo cavity, possible small trace of fluid in endo cavity, the uterus may remain enlarged for up to 2 weeks following SAB

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5
Q

Term for an abortion in which there are remaining products of conception in the uterus

A

Incomplete Abortion

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6
Q

Sono finds of incomplete AB

A

thickened or irregular endo echoes, possible fluid in endo cavity, increased endo vascularity on color doppler

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7
Q

Define missed abortion

A

the presence of an embryo without cardiac activity (the embryo may be retained for several weeks before the pt experiences symptoms)

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8
Q

List clinical symptoms of a missed AB

A

Low hCG levels in comparison to dates, loss of pregnancy symptoms, decrease in uterine size, brownish vaginal discharge without frank bleeding

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9
Q

Sono finds of a missed AB

A

embryo > 7mm without cardiac activity

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10
Q

Term for a SAB that is imminent and cannot be halted

A

Inevitable AB/ AB in progress

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11
Q

Inevitable AB clinical signs

A

cervical dilatation > 3 cm, rupture of membranes, bleeding for more than 7 days, persistent cramping

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12
Q

Sono finds of Inevitable AB

A

GS low in uterus or in cx (distinguished from Cx ectopic using color doppler) cervical dilatation, downward mvmt of GS during scan, anechoic crescent surrounding GS

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13
Q

A condition in which the future of the pregnancy may be at risk but the pregnancy continues

A

Threatened AB

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14
Q

Sono finds of a threatened AB

A

not able to diagnosis on US

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15
Q

Gestation in which the embryo does not develop or stops early in development and cannot be visualized

A

Anembryonic pregnancy aka Blighted ovum

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16
Q

List clinical signs of a blighted ovum

A

BhCG may rise but not as rapidly as expected
uterus is small for dates
vaginal spotting
closed cx

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17
Q

sono finds of a anembryonic pregnancy

A

no identifiable embryo in a GS measuring 25mm or larger
fluid-fluid level indicates blood and is positive evidence of embryonic death

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18
Q

Term for an abortion that results from the use of non-sterile instruments or from infection of retained products of conception

A

Septic AB

19
Q

List clinical symptoms and sono finds of a septic AB

A

clinical- signs of infection such as fever and leukocytosis
sono - enlarged uterus with heterogeneous contents, endo may have shadowing due to gas bubbles

20
Q

Implantation of the fertilized ovum at any site other than the endometrium

A

ectopic pregnancy

21
Q

Where is the most common site of ectopic pregnancies

A

in the ampulla of the oviduct (90% of cases)

22
Q

List reasons why the incidence of ectopic pregnancies has increased over the years

A

increased occurrence of PID, tubal reconstructive surgeries, assisted fertility programs

23
Q

T or F, Ov ectopics are common

A

F. They are rare

24
Q

Type of ectopic that is associated with high mortality rate due to risk of hemorrhage

A

Cervical ectopic. If treatment with methotrexate is unsuccessful, cervical artery embolization or total hysterectomy may be necessary.

25
Q

Type of ectopic that may progress further into gestation that other ectopics before it is recognized

A

Abdominal ectopic

26
Q

Coexisting intrauterine and extrauterine pregnancies

A

Heterotopic pregnancy

27
Q

In what types of pts do heterotopic pregnancies occur more in

A

Fertility pts who have undergone zygote or gamete transfer

28
Q

List clinical symptoms of an ectopic gestation

A

amenorrhea, vaginal bleeding or spotting, adnexal tenderness/ pelvic pain, shoulder pain (referred pain from intraperitoneal bleeding)

29
Q

Sono finds of an ectopic pregnancy

A

empty uterus, adnexal mass, “SLIDING SAC SIGN” (gentle pressure with TV transducer moves GS. Presence of endometrial decidual reaction or pseudosac, FF in posterior cul de sac, adx, pericolic gutters or morrisons pouch.

30
Q

Sonographic pitfalls of ectopic pregnancies

A

The presence of fluid in the endo cavity known as ‘Pseudogestational sac’. The absence of the double sac sign eliminates this pitfall.
Misidentification of corpus luteal cyst as an adnexal ectopic
Misidentification of a cornual/interstitial ectopic as an IUP.

31
Q

Which ectopic site is the most dangerous due to potential of hemorrhage

A

Cornual, interstitial

32
Q

Describe the characteristics you would expect to see on color doppler with an ectopic pregnancy

A

“ring of fire” surrounding the GS. High velocity, low resistance waveform.

33
Q

List treatment options for an ectopic

A

Methotrexate (MTX)
Laparoscopy
Exploratory laparotomy (less frequent)
Expectant management (no treatment if the pt is hemodynamically stable)

34
Q

Spectrum of pathologies resulting from the abnormal proliferation of trophoblastic tissue

A

Gestational trophoblastic disease

35
Q

List clinical finding of GTD

A

uterus large for dates, extremely elevated hCG levels, hyperemesis gravidarum, early onset of pre-eclampsia, hyperthyroidism, theca lutein cysts

36
Q

The most common form of GTD, The chorionic villi are hydropic without identifiable embryonic or fetal tissue

A

Complete hydatidiform mole

37
Q

Sono finds of a complete hydatidiform mole

A

enlarged ut filled with echogenic mass, hypervascular, low resistance flow, ov theca lutein cysts

38
Q

A form of GTD in which fetal and or embryonic tissue is frequently identified

A

Partial mole

39
Q

Sono finds of a partial mole

A

deformed GS, growth-restricted fetus with triploid anomalies, includinf syndactyly, and hydrocephalus, enlarged placenta with multiple cystic areas

40
Q

Gestation in which two conceptions occur, one normal and the other with GTD

A

Mole with coexisting normal fetus

41
Q

A patient has just had a normal term birth, her hCG levels still have yet to decline, what do you expect

A

Persistent Trophoblastic Neoplasia (PTN)

42
Q

Type of PTN that is most common, may cause uterine rupture, is a malignant NON-Metastatic GTD

A

Invasive mole aka chorioadenoma destruens

43
Q

Type of PTN that is malignant, metastatic, and very rare

A

Choriocarcinoma

44
Q

Sono finds of a choriocarcinoma

A

Elevated hCG levels in a nonpregnant pt, enlarged uterus, irregular complex mass with increased vasculature

OB GYN REGISTRY (19 decks)

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