Complications in Pregnancy Flashcards
What is a miscarriage?
Spontaneous loss of pregnancy before 24 weeks gestation
What is abortion?
Voluntary termination
What are spontaneous miscarriage classified into?
Threatened, inevitable, incomplete, complete, septic and missed
Describe a threatened miscarriage
Vaginal bleeding with possible pain
Viable pregnancy
Closed cervix on speculum examination
Describe an inevitable miscarriage
Viable pregnancy seen in uterus
Open cervix with bleeding that could be heavy and have clots
When is a missed miscarriage diagnosed?
No symptoms or could have bleeding/ brown loss vaginally
Gestational sac seen on screen
No clear foetus or foetal pole with no foetal heart seen
Describe an incomplete miscarriage
Most of pregnancy expelled out and some product of pregnancy remain in uterus
Open cervix and vaginal bleeding which may be heavy
Describe a complete miscarriage
Passed all products of conception, cervix closed and bleeding has stopped (ideally confirm POC or should have had scan previously)
What miscarriage can cause septic miscarriage?
Incomplete miscarriage
What is the aetiology of spontaneous miscarriage?
Abnormal foetal development - chromosome, genetic and structural
Uterine abnormality - congenital and fibroids
Cervical weakness
Maternal - increasing age and diabetes
Unknown
What is the management for threatened miscarriage?
Conservative
Most stop bleeding and are okay
What is the management for inevitable miscarriage?
If bleeding heavy may need evacuation
What is the management of missed miscarriage?
Conservative
Medical - prostaglandins (misoprostol)
Surgical - SMM (surgical management of miscarriage)
What is the management of septic miscarriage?
Antibiotics and evacuate uterus
What is an ectopic pregnancy?
Pregnancy implanted outside the uterine cavity
Mainly in ampulla of fallopian tubes
What are the risk factors for ectopic pregnancy?
Pelvic inflammatory disease
Previous tubal surgery
Previous ectopic
Assisted conception