Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Complications of Pregnancy 1 > Flashcards

Complications of Pregnancy 1 Flashcards

1
Q

Define spontaneous miscarriage/abortion

A

Termination/loss of pregnancy before 24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define still birth

A

Loss of pregnancy after 24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the categories of miscarriage?

A 
Threatened
Inevitable 
Partial 
Complete 
Missed
Septic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a threatened miscarriage?

A

Bleeding from gravid uterus before 24 weeks with closed cervix and viable pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the typical presentation of threatened miscarriage?

A

Vaginal bleeding and pain
Viable pregnancy
Closed cervix
Spontaneous abortion can be prevented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is an inevitable miscarriage?

A

PV bleeding + open cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the typical presentation of inevitable miscarriage?

A

Bleeding (may be heavy, may get clots), viable pregnancy and open os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an incomplete miscarriage?

A

Some production of conception are retained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the typical presentation of incomplete miscarriage?

A

PV bleeding, open cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a complete miscarriage?

A

Complete expulsion of products of conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the typical presentation of complete miscarriage?

A

Cervix closed and bleeding stopped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a septic miscarriage?

A

Ascending infection after incomplete miscarriage

Infection can spread throughout pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a missed miscarriage?

A

Foetal death but no expulsion of PoC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What will you see on Ex/USS if there is a missed miscarriage?

A

No symptoms/brown/bloody discharge, closed cervix

USS - empty gestational sac/no fetal heart seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the aetiologies of miscarriages?

A

Abnormal conceptus - chromosomal/structural/genetic abnormalities (50%)
Uterine abnormalities - submucosal fibroids, fusion failure of Mullerian ducts
Cervical impotence
Maternal factors - DM, increased age, SLE, thyroid disease, acute maternal infection
Unknown - hormonal imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which type of fibroids distort the uterine cavity the worst?

A

Submucosal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What occurs in cervical impotence that leads to miscarriage?

A

Cervix opens prematurely with absent/minimal uterine activity and pregnancy is expelled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What factors are linked to cervical impotence?

A

Trauma to cervix, e.g. following dilatation of cervix or cone biopsy treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can hormonal imbalances lead to miscarriage?

A

CL essential for survival in first 8 weeks of pregnancy
If CL removed –> abortion within 7 days
?Lower progesterone levels assoc with higher risk of miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can acute maternal infection lead to miscarriage?

A

General toxic illness with high temperature can stimulate uterine activity –> loss of pregnancy
E.g. appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the management of threatened miscarriage?

A

Watch and weight, avoid strenuous exercise, weakly pelvic USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the management of inevitable miscarriage?

A

May req. evacuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the management of missed miscarriage?

A

Prostaglandins/misoprostol to induce cervical ripening

Surgical miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the management of septic miscarriage?

A

Antibiotics and removal of PoC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define ectopic pregnancy

A

When an embryo implants in somewhere other than the uterine cavity (mostly fallopian ampulla)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the risk factors for ectopic pregnancy?

A

Alteration of the fallopian tubes, e.g. prev. ectopic in tubes, PID affecting tubes, surgery to tubes
Assisted conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the presentation of ectopic pregnancy?

A

Amenorrhoea, +ve preg test, and other signs of pregnancy

Vaginal bleeding, GI/urinary signs, abdominal pain/tenderness over ectopic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the presentation of tubal rupture in ectopics?

A

Acute onset severe abdominal and shoulder tip pain

Signs of haemorrhagic shock (tachycardia, hypotension, syncope)

29
Q

Why do you get shoulder pain in ruptured ectopics?

A

Blood irritates the diaphragm which is supplied by same nerve that supplies shoulder
(Referred pain)

30
Q

What investigations should you do for ectopic pregnancies?

A

TUVS (thickened endometrium with no gestational sac in the uterus, fluid in pouch of douglas)
Serum beta-hCG, progesterone

31
Q

How can you manage ectopic pregnancy?

A

Methotrexate (interfers with folate dependent steps in making DNA in rapidly diving ectopic)
Surgical - salphingectomy (removal of tubes), salphinotomy (removal of pregnancy - assoc. with higher risk of recurrence)
Conservative if haemodynamically stable & uncomplicated as may resolve itself

32
Q

Define antepartum haemorrhage

A

Haemorrhage from the genital tract after the 24th week up until birth

33
Q

What are the causes of APH?

A 
Placenta praevia
Vasa praevia 
Placental abruption 
APH of unknown origin 
Local lesion of the genital tract
34
Q

What local lesions of the genital tract may lead to APH?

A

Cervical erosions, polyps, cancer

35
Q

What STI may lead to blood discharge?

A

Trichomonas

36
Q

What is placenta praevia?

A

Placenta lying in lower uterine segment

37
Q

What are RFs for placenta praevia?

A

Previous C-section, multiparous woman, multiple pregnancy

38
Q

What is the classification of placenta praevia?

A

1 - lying in lower uterine segment, but not touching internal os
2 - reaches internal os
3 - eccentrically covers os
4 - central placenta praevia

39
Q

What is the presentation of placenta praevia?

A

Painless PV
Soft, non-tender uterus
Malpresentation of foetus

40
Q

Why do you get bleeding in placenta praevia?

A

Separation of placenta as lower uterine segment forms the cervical effaces

41
Q

How do you diagnose placenta praevia?

A

USS
Bladder is good landmark for the lower uterine segment
MRI better but not widely available

42
Q

How do you manage placenta praevia?

A

DO not do vaginal Ex
Cross match and transfuse if req.
Conservative approach to allow foetal maturity
C-section delivery

43
Q

How do you manage PPH?

A

Oxytocin, ergometrine, carbaprost, tranexamic acid
Balloon tamponade
B lynch suture, ligation of uterine/iliac vessels/hysterectomy

44
Q

Define placental abruption

A

Placenta has started to separate from uterine wall

Assoc. with retroplacental clot

45
Q

In placental abruption which vessels are bleeding?

A

Mothers and foetal

46
Q

What are the RFs for placental abruption?

A 
Cocaine
Smoking, increased age, parity
Multiple pregnancy 
Pre-eclampsia/HTN 
Polyhydramnios 
Previous abruption
47
Q

What are the types of placental abruption?

A

Revealed
Concealed
Mixed

48
Q

What is the presentation of the revealed placental abruption?

A

Major haemorrhage apparent as blood leaks down from os

49
Q

What is the presentation of concealed placental abruption?

A

Haemorrhage occurs between placenta and uterine wall
Increase in fungal height
May get couvelaire uterus

50
Q

What is a couvelaire uterus?

A

Blood leaks into uterine wall and gives it bruised appearance

51
Q

What is the presentation of placental abruption?

A

Pain - abdominal, severe and tenderness
Vaginal bleeding
Increased uterine activity (may go into premature labour)
Foetal distress

52
Q

How do you diagnose placental abruption?

A

USS

53
Q

How do you manage placental abruption?

A

Attempt vaginal delivery or C-section

54
Q

What are complications of placental abruption?

A

Maternal shock, collapse, DIC
PPH
Couvelaire uterus

55
Q

Define vasa praevia

A

Foetal vessels located in membranes near internal os of cervix, putting them at risk when membranes rupture

56
Q

Where is the blood loss from in vasa praevia?

A

Foetal blood

Hence is catastrophic to the foetus

57
Q

What are RF for vasa praevia?

A

Placental abnormalities, placenta praevia, IVF

58
Q

What are the clinical features of placenta praevia?

A

Painless PV bleeding, occurring after rupture of membranes, foetal distress

59
Q

What is the management of vasa praevia?

A

Emergency C-section if foetal distress

60
Q

Define pre-term labour

A

Labour before 37 weeks

61
Q

Define mild, very and extremely preterm

A

Mild - 32-26wks
Very - 28-32wks
Extremely - 24-28wks

62
Q

What are the factors predisposing to premature labour?

A 
Polyhydramnios 
Multiple pregnancy 
APH 
Pre-eclampsia
Infection, UTI, STI 
Premature rupture of membranes
Idiopathic
63
Q

<24-26wks premature labour is associated with what prognosis?

A

Very poor prognosis

64
Q

What is the management of premature labour?

A

Tocolysis (anti-contraction meds) to allow steroids/transfer
NICU
Steroids to improve lung maturity/surfactant production
Aim for vaginal deliver

65
Q

What are the neonatal complications assoc. with premature delivery?

A

IRDS (surfactant deficiency disorder –> alveolar collapse –> tachycardia, tachypnoea, increased resp effort, cyanosis)

Intraventricular haemorrhage

Cerebral palsy

Others: nutrition, temp control, jaundice, infections, visual/hearing impairment

66
Q

What is cerebral palsy?

A

Group of disorders affecting muscle tone/development of movement/posture

67
Q

What causes cerebral palsy?

A

Damage to the foetal brain in utero/brain during infancy

68
Q

What symptoms are caused by cerebral palsy?

A

Spasticity/apraxia/dysarthria etc.

Reproduction (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions