Complications in Pregnancy 1 Flashcards
What is a miscarriage?
Spontaneous loss of pregnancy before 24 weeks gestation.
To be any kind of miscarriage, should happen before 24 weeks.
What are the different kinds of miscarriage?
Threatened Inevitable Incomplete Septic Complete Missed
What is a threatened miscarriage?
- Vaginal bleeding/pain
- Viable pregnancy
- Closed cervix
How do you manage a threatened miscarriage?
Conservative treatment
What is an inevitable miscarriage?
- Viable pregnancy
* Open cervix with bleeding (+/- clots)
How do you manage an inevitable miscarriage?
May need evacuation
What is an incomplete miscarriage?
• Most of pregnancy expelled • Open cervix, vaginal bleeding
How do you manage an incomplete miscarriage?
- Evacuate RPOC
* Might progress to septic
What is a septic miscarriage?
Infection of RPOC
How do you manage a septic miscarriage?
Antibiotics and evacuate uterus
What is a complete miscarriage?
- Passed all POC
* Cervix closed and bleeding has stopped
What is a missed miscarriage?
Foetus has died but uterus has not tried to expel
How do you diagnose a missed miscarriage?
- Gestational sac seen on scan
- No clear foetus
- No foetal heart
How do you manage a missed miscarriage?
- Prostaglandins e.g. misoprostol
* Surgical e.g. surgical management of miscarriage
Causes of spontaneous miscarriage?
- Maternal - age, DM
- Abnormal conceptus - chromosomal, structural
- Uterine abnormality - congenital, fibroids
- Cervical weakness - trauma, hormonal condition
How does an ectopic pregnancy present?
- Amenorrhoea
- +ve pregnancy test
- +/- vaginal bleeding
- +/- abdo pain
- +/- GI symptoms
Abdo pain + woman of childbearing age