Complications of Pregnancy Flashcards
What amount of HCG determines viability?
20-25 IU/L or higher
Define spontaneous abortion
Recognized pregnancy loss before 20th wk gestation
80% occur in first 12 weeks
Fetal factors that can cause spontaneous abortion
- Chromosomal abnormalities
- Congenital anomalies
- Exposure to teratogens
- Trauma
Maternal factors that can cause spontaneous abortion
- Advanced maternal age
- Previous spontaneous abortion
- Uterine structural issues
- Maternal disease
- Smoking, alcohol, cocaine, NSAIDs
- Extremes in weight
What is the most useful test to evaluate suspected spontaneous abortion?
Pelvic U/S - detects cardiac fetal activity at 5.5-6 weeks
When does pelvic U/S detect cardiac fetal activity?
5.5 - 6 weeks gestation
Define missed abortion
Fetus has died but still in the uterus
Define complete abortion
Pregnancy completely expelled from uterus
Define septic abortion
- Abortion w/intrauterine infection (S. aureus)
- MC a/w induced abortion
Define empty sac abortion
- Embryonic development arrested at a very early stage or failed altogether
- Sac larger than 25 mm w/o evidence of embryonic tissue
Define ectopic pregnancy
Pregnancy outside of the uterus (MC fallopian tube)
MC site of ectopic pregnancy?
Ampulla of fallopian tube
How can an ectopic pregnancy be managed medically?
Methotrexate
Criteria to give methotrexate for tx of ectopic pregnancy
One of:
- Less than 6 wks
- Tubal mass less than 3.5 cm in diameter
- Fetus has died
- B-HCG less than 15,000 mIU
What type makes up most cases of GTD?
Complete and partial moles (noninvasive localized tumors)
Risk factors of GTD
- Extremes in age (older than 35, younger than 20)
- History of previous GTD
Presentation of GTD
- Hyperemesis gravidarum
- Hyperthyroidism
- Preeclampsia before 20 wks
What condition causes preeclampsia before 20 wks gestation?
Gestational trophoblastic disease (GTD)
What condition causes snowstorm appearance on U/S?
Gestational trophoblastic disease (GTD)
Major HTN disorders in pregnancy
- Gestational HTN
- Chronic HTN
- Preeclampsia-eclampsia
- Preeclampsia-eclampsia on chronic HTN
Define gestational HTN
- Increased BP after 20 wks
- No proteinuria
Define chronic HTN
- BP 140/90 or higher before pregnancy or 20 wks gestation
- HTN diagnosed after 20 wks gestation but persists after 12 wks postpartum
Define preeclampsia-eclampsia
New onset HTN and either proteinuria or end organ dysfunction
When is eclampsia diagnosed?
When seizures occur
