Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam - M - Reproduction System (Megan and Rachel) > common pathologies of pregnancy > Flashcards

common pathologies of pregnancy Flashcards

1
Q

what is ectopic pregnancy

A

pregnancy implanted outside of uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where does an ectopic pregnancy most commonly implant

A

fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where are less common places for an ectopic pregnancy to implant

A

ovary
cervix
abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are risk factors for an ectopic pregnancy

A 
previous ectopic pregnancy 
previous pelvic inflammatory disease 
previous surgery to fallopian tubes 
intrauterine devices 
older age 
smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does ectopic pregnancy present

A

missed period
lower abdominal pain in L or R iliac fossa
vaginal bleeding
lower abdominal or pelvic tenderness
cervical motion tenderness
can present with acute abdominal pain and haemorrhage if it ruptures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are signs of an ectopic pregnancy that has ruptured

A

acute abdominal pain
syncope
shoulder tip pain
shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what investigations could you do in ectopic pregnancy

A

transvaginal US

serum hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what indicated ectopic pregnancy on US

A

gestational sac in fallopian tube

non-specific mass that moves separately from the ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what serum hCG results indicate ectopic pregnancy

A

rise of <63% in 48hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

are ectopic pregnancies viable

A

no

all ectopic pregnancies need to be terminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is expectant management of ectopic pregnancy

A

waiting for the pregnancy to be terminated naturally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are requirements for expectant management

A 
need to follow up 
ectopic can't be ruptured 
<35mm 
no visible heart beat 
no significant pain 
hCG <1500 IU/l
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do you manage ectopic pregnancy medically

A

methotrexate IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are requirements for medical management of ectopic pregnancy

A

HCG < 5000IU/l

confirmed absence of intrauterine pregnancy on US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are side effects of methotrexate

A

vomiting
nausea
abdominal pain
stomatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you manage ectopic pregnancy surgically

A

first line: laparoscopic salpingectomy (removal of pregnancy with fallopian tube)
second line/patients with increased risk of infertility: laparoscopic salpingotomy (removal of pregnancy from fallopian tube and repair of tube)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is miscarriage (early vs late)

A

spontaneous termination of pregnancy
early is <12weeks
late is 12-24weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

missed miscarrige

A

no symptoms

foetus dead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

threatened miscarrige

A

vaginal bleeding with closed cervix

foetus still alive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

inevitable miscarrige

A

vaginal bleeding with open cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

incomplete miscarrige

A

retained products of conception after miscarrige

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

complete miscarrige

A

no RPOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

anembryonic pregnancy

A

gestational sac present but no embryo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does miscarrige present

A

vaginal bleeding

previous positive pregnancy test/missed periods

25
Q

what investigations can you do in miscarrige

A

TVUS - foetal heart beat, foetal pole

26
Q

when is the foetal heart beat expected

A

when crown-rump length is >7mm

27
Q

what does a foetal pole indicate

A

expected when mean gestational sac diameter is >25mm

if there is no foetal pole it is an anembryonic pregnancy

28
Q

what confirms a non-viable pregnancy on US

A

no foetal heartbeat when the crown-rump length is >7mm

29
Q

what confirms an anembryonic pregnancy on US

A

no foetal pole when gestational sac diameter is >25mm

30
Q

how do you manage a pregnancy with bleeding <6wks

A

expectant management
repeat urine pregnancy test after 7-10days
refer if bleeding continues or if there is pain

31
Q

how do you manage a pregnancy with bleeding >6wks

A

refer to EPAU
US scan
expectant, medical or surgical management

32
Q

what is expectant management in miscarrige/bleeding in pregnancy

A

1-2 weeks to allow miscarrige to occur

repeat pregnancy test

33
Q

what is medical management for miscarrige

A

misoprostol - vaginal suppository or oral dose

34
Q

what is surgical management for miscarrige

A

manual vacuum aspiration under local anaesthetic
electric vacuum aspiration under general

give prostaglandins (misoprostol) before surgical management

35
Q

what is molar pregnancy

A

hydatidiform mole is a type of tumour that grows like a pregnancy in the uterus

36
Q

how is a molar pregnancy formed

A

too many methylated genes from the sperm causes

37
Q

how can a molar pregnancy present

A 
more severe morning sickness 
vaginal bleeding 
increased enlargement of uterus 
high hCG
thyrotoxicosis
38
Q

what investigations could you do for molar pregnancy

A

US - snow storm appearance

histology to confirm

39
Q

how do you manage a molar pregnancy

A

evacuation of uterus
refer to gestational trophoblastic disease centre
monitor hCG levels
systemic chemo if metastasises

40
Q

what is chorioamnionitis

A

infection of chorioamniotic membranes and amniotic pavements

41
Q

how does chorioamnioitis happen

A

ascending infection travels up vagina

usually e.coli

42
Q

how can chorioamnionitis present

A 
fever
raised neutrophils 
abdominal pain 
uterine tenderness 
vaginal discharge
43
Q

what investigations could you do in chorioamnionitis

A

urine dipstick and culture
bloods
vaginal swab

44
Q

how can you manage chorioamnionitis

A

maternal and foetal monitoring
CS if fetal distress
antibiotics

45
Q

what are complications of chorioamnionitis

A

intrauterine death

cerebral palsy - neutrophils aggravate cells in brain and the cells get damaged in natural hypoxic state of labour

46
Q

can opiates cross the placenta

A

yes - small molecules

47
Q

what effect do opiates have on a fetus

A

don’t interfere with fetal growth/development but fetus will go into withdrawal as soon a it is born

48
Q

what is management for drug abuse in pregnancy

A

manage baby on neonatal unit for withdrawal for 5 days

on week 3 baby will over feed and use constant mouthing movements - sign of methadone withdrawal

49
Q

what is placental abruption

A

separation of part of placenta from uterine wall before delivery
a haematoma will collect behind it

50
Q

concealed vs revealed abruption

A

concealed - cervix remains closed, no vaginal bleeding

revealed - blood loss observed via vagina

51
Q

what are risk factors for placental abruption

A 
previous abruption 
pre-eclampsia 
bleeding in early pregnancy 
trauma 
multiple pregnancy 
fetal growth restriction 
smoking 
increased maternal age 
cocaine or methamphetamine use
52
Q

what can cause placental abruption

A

hypertension
cocaine
trauma

53
Q

how can placental abruption present

A

antepartum haemorrhage (vaginal bleeding)
sudden onset severe abdominal pain
shock
CTG abnormalities

54
Q

how do you manage placental abruption

A 
emergency 
may need emergency CS 
2 cannulas + bloods + crossmatch 4 units 
fluid and blood resuscitation 
steroids if preterm delivery
55
Q

what are complications of placental abruption

A

baby can become hypoxic

antepartum haemorrhage

56
Q

what is an over twisted cord

A

when the umbilical cord twists round it’s self and results in poor blood flow

57
Q

what causes an over twisted cord

A

normal movements of baby

58
Q

what are complications of an over twisted cord

A

ischaemia/poor blood flow to baby

intrauterine death

Exam - M - Reproduction System (Megan and Rachel) (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions