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Special Pops - Women's Health > Complications of Pregnancy > Flashcards

Complications of Pregnancy Flashcards

1
Q

What amount of HCG determines viability?

A

20-25 IU/L or higher

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2
Q

Define spontaneous abortion

A

Recognized pregnancy loss before 20th wk gestation

80% occur in first 12 weeks

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3
Q

Fetal factors that can cause spontaneous abortion

A
  • Chromosomal abnormalities
  • Congenital anomalies
  • Exposure to teratogens
  • Trauma
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4
Q

Maternal factors that can cause spontaneous abortion

A
  • Advanced maternal age
  • Previous spontaneous abortion
  • Uterine structural issues
  • Maternal disease
  • Smoking, alcohol, cocaine, NSAIDs
  • Extremes in weight
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5
Q

What is the most useful test to evaluate suspected spontaneous abortion?

A

Pelvic U/S - detects cardiac fetal activity at 5.5-6 weeks

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6
Q

When does pelvic U/S detect cardiac fetal activity?

A

5.5 - 6 weeks gestation

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7
Q

Define missed abortion

A

Fetus has died but still in the uterus

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8
Q

Define complete abortion

A

Pregnancy completely expelled from uterus

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9
Q

Define septic abortion

A
  • Abortion w/intrauterine infection (S. aureus)

- MC a/w induced abortion

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10
Q

Define empty sac abortion

A
  • Embryonic development arrested at a very early stage or failed altogether
  • Sac larger than 25 mm w/o evidence of embryonic tissue
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11
Q

Define ectopic pregnancy

A

Pregnancy outside of the uterus (MC fallopian tube)

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12
Q

MC site of ectopic pregnancy?

A

Ampulla of fallopian tube

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13
Q

How can an ectopic pregnancy be managed medically?

A

Methotrexate

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14
Q

Criteria to give methotrexate for tx of ectopic pregnancy

A

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
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15
Q

What type makes up most cases of GTD?

A

Complete and partial moles (noninvasive localized tumors)

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16
Q

Risk factors of GTD

A
  • Extremes in age (older than 35, younger than 20)

- History of previous GTD

17
Q

Presentation of GTD

A
  • Hyperemesis gravidarum
  • Hyperthyroidism
  • Preeclampsia before 20 wks
18
Q

What condition causes preeclampsia before 20 wks gestation?

A

Gestational trophoblastic disease (GTD)

19
Q

What condition causes snowstorm appearance on U/S?

A

Gestational trophoblastic disease (GTD)

20
Q

Major HTN disorders in pregnancy

A
  1. Gestational HTN
  2. Chronic HTN
  3. Preeclampsia-eclampsia
  4. Preeclampsia-eclampsia on chronic HTN
21
Q

Define gestational HTN

A
  • Increased BP after 20 wks

- No proteinuria

22
Q

Define chronic HTN

A
  • BP 140/90 or higher before pregnancy or 20 wks gestation

- HTN diagnosed after 20 wks gestation but persists after 12 wks postpartum

23
Q

Define preeclampsia-eclampsia

A

New onset HTN and either proteinuria or end organ dysfunction

24
Q

When is eclampsia diagnosed?

A

When seizures occur

25
Q

Define HELLP syndrome

A

Hemolysis
Elevated Liver enzymes
Low Platelets
(a variant of preeclampsia)

26
Q

What is the cure for preeclampsia?

A

Delivery of fetus

27
Q

Medical treatment of preeclampsia

A
  • Mg sulfate
  • Anti-HTNs
  • Anticonvulsants
  • *Delivery is cure
28
Q

What is Rh incompatibility during pregnancy a/w?

A

Anemia leading to fetal hydrops

29
Q

Screening for gestational diabetes

A
  • Everyone screened using GTT

- After 26 weeks (may do early screening but follow up always needed)

30
Q

What is NOT a/w premature rupture of membranes?

A

Single pregnancy

31
Q

Risk factors for PROM

A
  • Previous PROM
  • Genital tract infection
  • Antepartum bleeding
  • Cigarette smoking
32
Q

How does placenta previa present?

A

Painless vaginal bleeding

33
Q

What pregnancy complication causes painless vaginal bleeding?

A

Placenta previa

34
Q

How does placental abruption present?

A

Vaginal bleeding with abdominal pain

35
Q

Abnormalities that cause dystocia?

A

Abnormalities of:

  1. Powers (uterine contractility and maternal expulsive effort)
  2. Passenger (fetus)
  3. Passage (pelvis)
36
Q

MC complication causing C section?

A

Cephalopelvic disproportion

37
Q

Woman with previous C section due to a low lying fibroid, what risk is of concern in future pregnancy?

A

Rupture of uterus even prior to onset of labor

38
Q

Requirements for vaginal birth after cesarean (VBAC)

A
  • Vertex
  • Only 1 prior C section
  • Previous C section more than 18 months ago
  • Full consent of patient
  • Available OR for emergency C section
  • Blood available
  • No pitocin, prostaglandins
39
Q

Major cause of maternal morbidity and mortality?

A

Postpartum hemorrhage

Special Pops - Women's Health (11 decks)

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