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MCN 2 Lec (Prelims) > Complications in Pregnancy > Flashcards

Complications in Pregnancy Flashcards

1
Q

Implantation occurred outside the uterine cavity

A

Ectopic Pregnancy

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2
Q

The most common site for ectopic pregnancy

A

Fallopian tubes

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3
Q

Fallopian tube sites for ectopic pregnancies

A

80% - ampullar portion
12% - isthmus
8% - interstitial or fimbrial

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4
Q

Fertilization occurs as usual in the fallopian tubes

A

Ectopic Pregnancy

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5
Q

Ectopic pregnancy factors

A
  1. Congenital anomalies like webbing
  2. Smoking tobacco
    3.
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6
Q

Sharp stabbing pain in lower abdominal quadrant

Vaginal spotting

A

Ruptured Ectopic Pregnancy

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7
Q

Amount of bleeding not evident
May lead to shock
Falling hCG level

A

Ruptured Ectopic Pregnancy

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8
Q

Abnormal proliferation and then degeneration of the trophoblastic villi or cells become filled with fluid and appears as fluid filled grape sized vesicles

A

Gestational Trophoblastic Disease (Hydatidiform mole)

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9
Q

Two types of moles

A

Complete Mole
Partial Mole

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10
Q

A type of mole that all trophoblastic villi swell and become cystic

A

Complete mole

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11
Q

A type of mole that some of the villi forms normally

A

Partial mole

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12
Q

Uterus tends to expand faster

Strong (+) result of hCG- 1 to 2 M IU compared to a normal of 400,000IU)

Symptoms of pregnancy induced hypertension may appear before the 20th week (5th month)

Ultrasound-no fetal growth and fetal heart sound

Marked nausea and vomiting

Dark brown blood, profuse flesh flow(16 weeks) with clear fluid filled vesicles ( dark brown resembles prune juice)

A

Assessment for Gestational Trophoblastic Disease

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13
Q

Suction curettage
Post surgery:
Pelvic examination, chest radiograph,hCG level

hCG monitoring

Half of woman positive at 3 weeks

¼ positive result at 40 days

Assess every 2 weeks until normal

Every 4 weeks for the next 6 to 12 months

Should use reliable. contraceptive method

Plan pregnancy at 12 months if hcg is normal

A

Therapeutic Management for Gestational Trophoblastic Disease

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14
Q

Medication to end ectopic pregnancy or trophoblastic disease

A

Methotrexate

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15
Q

used only in cancer chemotherapy slowly stops the growth of cancer cells of the body only if it has metastasis

A

Dactinomycin

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16
Q

Primary Causes of Bleeding during Pregnancy

Vaginal spotting, perhaps slight cramping

A

Threatened Spontaneous Miscarriage

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17
Q

Primary Causes of Bleeding during Pregnancy

Vaginal spotting, cramping, cervical dilatation

A

Imminent (inevitable) Miscarriage

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18
Q

Primary Causes of Bleeding during Pregnancy

Vaginal spotting, perhaps slight cramping, no apparent loss of pregnancy

A

Missed Miscarriage

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19
Q

Primary Causes of Bleeding during Pregnancy

Vaginal spotting, cramping, cervical dilatation, but incomplete expulsion of uterine contraction

A

Incomplete Spontaneous MIscarriage

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20
Q

Primary Causes of Bleeding during Pregnancy

Vaginal spotting, cramping, cervical dilatation, and complete expulsion of uterine contents

A

Complete Spontaneous Miscarriage

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21
Q

It is always a serious situation in pregnancy because it has the potential to diminish the blood supply to both the pregnant patient and fetus

A

Vaginal bleeding

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22
Q

It is the loss of a pregnancy before 20 weeks

A

Spontaneous miscarriage

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23
Q

Implantation outside of the uterus, usually in a fallopian tube

A

Ectopic pregnancy

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24
Q

A procedure is necessary to remove the conceptus and repair or remove the tube to half bleeding

A

Laparoscopic

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25
Q

An abnormal overgrowth of trophoblastic cells

A

Gestational Trophoblastic Disease

26
Q

If gestational trophoblastic disease is not yet discovered under an ultrasound, what will happen?

A

Bleeding and expulsion of the abnormal growth occur at about the 16th week of pregnancy

27
Q

Patients with gestational trophoblastic disease needs a close follow-up because of what situation?

A

It can lead to choriocarcinoma (malignancy)

28
Q

Occurs when the cervix dilates early in pregnancy before viability of the fetus

A

Premature Cervical Dilatation

29
Q

What kind of suture can be placed to prevent the cervix from dilating when having a premature cervical dilatation?

A

Cervical cerclage

30
Q

Premature Cervical Dilatation

A kind of procedure where a nylon sutures are placed horizontally and vertically across the cervix and pulled tight to reduce the cervical canal

A

McDonald procedure

31
Q

Premature Cervical Dilatation

A kind of procedure where sterile tape is threaded in a purse-string manner under the submucous layer of the cervix and sutured in place to achieve a closed cervix

A

Shirodkar technique

32
Q

The low implantation of the placenta so that it crosses the cervical os

A

Placenta Previa

33
Q

What will happen when placenta previa is not yet discovered?

A

Cervical dilatation may cause the placenta to tear, causing severe blood loss

34
Q

Four Degrees of Placenta Previa

Implantation in the lower rather than in the upper portion of the uterus

A

Low-Lying Placenta

35
Q

Four Degrees of Placenta Previa

The placenta edge approaches that of the cervical os

A

Marginal implantation

36
Q

Four Degrees of Placenta Previa

Implantation that occludes a portion of the cervical os

A

Partial Placenta Previa

37
Q

Four Degrees of Placenta Previa

Implantation that totally obstructs the cervical os

A

Total Placenta Previa

38
Q

A blood disorder that may occur with any trauma, so it can accompany such conditions as premature separation of the placenta and hypertension in pregnancy

A

Disseminated Intravascular Coagulation (DIC)

39
Q

Blood coagulation is extreme at one site of the circulatory system that clotting factors become diminished, resulting in their absence in the remainder of the system

A

Disseminated Intravascular Coagulation (DIC)

40
Q

Labor that occurs after 20 weeks and before the end of the 37th week of pregnancy

A

Preterm Labor

41
Q

Tearing of the fetal membranes with loss of amniotic fluid before the pregnancy is at term

A

Preterm rupture

42
Q

A unique disorder that occurs with two classic symptoms: hypertension and proteinuria

A

Preeclampsia

43
Q

A unique form of gestational hypertension marked by hemolysis of red blood cells, elevated liver enzymes, and a low platelet count

A

HELLP Syndrome

44
Q

Pregnancy that extends beyond 42 weeks

A

Postterm Pregnancy

45
Q

Overproduction of AF

A

Polyhydramnios

46
Q

Too little AF

A

Oligohydramnios

47
Q

Normal AF measurement

A

500 - 1000ml

48
Q

A possibility when a patient who is Rh negative is sensitized and carries a fetus who is Rh positive

A

Isoimmunization

49
Q

If with threatened miscarriage, coitus should proceed or not?

A

Abstain from coitus at least 2 weeks

50
Q

It refers to the cervix that dilates prematurely and therefore cannot retain a fetus until term

A

Premature Cervical Dilatation

51
Q

Suggested bed rest position after suture surgery from premature cervical dilatation

A

Slight or modified Trendelenburg position

52
Q

Occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy

A

Premature Cervical Dilatation

53
Q

Developed an elevated BP of 140/90mmHg after 20 weeks of gestation but no proteinuria or edema

A

Gestational Hypertension

54
Q

Having seizure from preeclampsia

A

Eclampsia

55
Q

Above of gestational hypertension but below levels of having seizures

A

Preeclampsia

56
Q

Preeclampsia without severe features

A
  1. Having proteinuria
  2. BP rise to 140/90mmHg, taken on two occasions at least 4hrs apart
57
Q

BP rises to 160/110mmHg or above on at least two occasions 4hr apart at bed rest

A

Preeclampsia with severe features

58
Q

Factors of having preeclampsia with severe features

A
  1. BP reading 160/110mmHg or diastole of 30mmHg in addition to current BP reading
  2. Platelet count below 100,000
  3. Elevated liver enzymes above twice the normal limit
  4. Serum creatinine level above 1.1mg/dL
  5. Pulmonary edema
  6. New-onset severe backache - not relieved with medications
  7. Visual disturbances
59
Q

Most severe classification of pregnancy-related hypertensive disorders

A

Eclampsia

60
Q

Antiplatelet therapy medication for preeclampsia without severe features

A

Low-dose aspirin

61
Q

Examples of hypotensive drugs

A
  1. Hydralazine (Apresoline)
  2. Labetalol (Normodyne)
  3. Nifedipine

MCN 2 Lec (Prelims) (6 decks)

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