Complications in Pregnancy 1

Question 1

Define spontaneous miscarriage.

Answer 1

• a termination/loss of pregnancy before 24 weeks gestation

Question 2

List the categories of spontaneously miscarriage.

Answer 2

• threatened
• inevitable
• incomplete
• complete
• septic
• missed

Question 3

State the incidence of spontaneous miscarriage.

Answer 3

• 15%

Question 4

Describe a threatened miscarriage.

Answer 4

• bleeding from the gravid uterus before 24 weeks gestation
• viable fetus
• no evidence of cervical dilation
• may or may not be pain

Question 5

Describe an inevitable miscarriage.

Answer 5

• dilation of the cervix

- bleeding which may be heavy

Question 6

Describe an incomplete miscarriage.

Answer 6

• only partial expulsion of the products of conception

- bleeding may or may not be heavy

Question 7

Describe a complete miscarriage.

Answer 7

• complete expulsion of the products of conception
• cervix will be closed
• all bleeding will have stopped

Question 8

Describe a septic miscarriage.

Answer 8

• following an incomplete abortion there is a risk of ascending infection into the uterus which can spread throughout the pelvis

Question 9

Describe a missed miscarriage.

Answer 9

• the fetus has died but the uterus has made no attempt to expel the products of conception
• usually no symptoms
• gestational sac may be seen on scan

Question 10

List aetiological factors which may contribute to a spontaneous abortion.

Answer 10

• abnormal conceptus
• uterine abnormality
• cervical incompetence
• maternal
• unknown

Question 11

Define an ectopic pregancy.

Answer 11

• a pregnancy in which implantation has occurred outside the uterine cavity

Question 12

List some risk factors for ectopic pregnancy.

Answer 12

• pelvic inflammatory disease
• previous tubal surgery
• previous ectopic
• assisted conception

Question 13

Give a typical presentation of an ectopic pregnancy.

Answer 13

• period of amenorrhoea with a positive pregnancy test
• vaginal bleeding
• abdominal pain
• GI or urinary symptoms

Question 14

Define an antepartum haemorrhage.

Answer 14

• haemorrhage from the genital tract after the 24th week of pregnancy but before the delivery of the baby

Question 15

List some causes of APH.

Answer 15

• placenta praevia
• placenta abruption
• Local lesions of the genital tract
• Vasa praevia

Question 16

Describe placenta praevia.

Answer 16

• the placenta is attached to the lower segment of the uterus

Question 17

Describe placenta abruption.

Answer 17

• placenta has started to separate from the uterine wall before the birth of the baby
• associated with retroplacental clot
• can be classified as concealed, mixed or revealed

Question 18

Describe vasa praevia.

Answer 18

• rupture of a fetus vessel within the fetal membranes

- blood loss is fetal, not maternal

Question 19

At how many weeks would a baby be describe as mildly preterm?

Answer 19

32-36 weeks

Question 20

How would you describe a birth at 24-28 weeks?

Answer 20

• extremely preterm

Question 21

List some predisposing factors of preterm labour.

Answer 21

• multiple pregnancy
• polyhydraminos
• APH
• Pre-eclampsia
• Infection
• Prelabour premature rupture of membranes