Complicated Pregnancy Flashcards
Spontaneous abortion
MIscarriage of pregnancy less than 20 weeks.
20% of recognized pregnancies miscarry
80% in first trimester, usually do to chromosomal abnormality
Spontaneous abortion S/S
Bleeding, bright red MIdline cramping Low back pain Expulsion of products of conception os open OR closed
Threatened abortion
Slight bleeding abd vramping Cervical os CLOSED Uterine size compatible w/ dates No products of conception passed
Incomplete abortion
Usually the placenta stays in uterus
Complete abortion
All contents passed including placenta
Threatened abortion mgmt
Bed rest 24-48 hrs No work or responsibilities No intercourse Rest in horizontal position Hydration NO hormones
Ectopic pregnancy
Implantation of fertilized ovum outside uterine cavity.
Fallopian tube is most common
Rupture is inevitable
1 in 80 pregnancies
Major cause of maternal death in first tri
Ectopic preg s/s
1-2 months of amenorrhea DIarrhea, urge to defecate Mower abd pain, sudden and severe, adnexal Referred pain to shoulder Tender adnexal mass
B-hCG in ectopic
Will be lower than a normal pregnancy of same duration
Ectopic tx
Laproscopy
Methotrexate for stable pt’s
Hydatidiform Mole
Benign neoplasm of chorion where villi become transparent vessicles.
Occurs when a single sperm fertilizes egg w/o nucleus
Hydatidiform Mole S/S
Bleeding, enlarged uterus Pelvic pain, anemia Hyperemesis gravidarum Preeclampsia Passage of hydropic vesicles
B-hCG for Hydatidiform Mole would be
Very high for gestational age
Hydatidiform Mole US
Absence of gestational sac SNowy uterus (multiple echogenic regions)
Hydatidiform Mole pregnancy delay
Should not get pregnant until B-hCG levels are normal for a YEAR.
Choriocarcinoma
Rare, highly malignant
Causes ulcerating surfaces into endometrial cvity
Mets to lung, brain
Choriocarcinoma Tx
Highly sensitive to chemo (TOC)
Placenta Previa
Placenta implanted in lower segment of uterus and lies near cervical os
Placenta Previa presentation
Painless bleeding in 3rd tri (bright red)
fetal heart tones normal
Dx best made w/ US
Should a pelvic exam be done on suspected placenta previa?
No, do an US
Abruptio Placentae
Placental abruption
Partial or complete detachment or normally implanted placenta
Usually 3rd tri
Abruptio Placentae risks`
Abd trauma Cocaine SMoking Eclampsia HTN
Abruptio Placentae S/S
Vaginal bleeding
Abd, back pain
Uterine contractions
abnormal Fetal heart pattern
All pregnant women with abd pain, contractions and bleeding need to have what ruled out?
Abruptio Placentae
