Complications of pregnancy

Question 1

1st trimester
2nd trimester
3rd trimester

Answer 1

1-12
13-27
28-40

Question 2

age of viability

Answer 2

24 weeks

Question 3

various body changes during pregnancy?

Answer 3

• hypercoaguable state
• increased pH from resting hyperventilation
• decreased systemic vascular resistance
• progesterone relaxes smooth muscle leading to decreased peristalsis
• decreased creatinine

Question 4

MCC of meternal mortality

Answer 4

• PE

- HTN (pre-eclampsia/eclampsia)

Question 5

complications of twins

Answer 5

one fetus will take more and the other know will be anemic and the other polycythemic

Question 6

vanishing twin

Answer 6

If the twin vanishes very early, the remaining twin is usually fine, however if one twin vanishes in the 2nd/3rd trimester there is a higher risk for the other fetus

Question 7

most serious risk of multiple gestations

Answer 7

spontaneous preterm birth from stretch of the uterus

Question 8

Braxton hicks

Answer 8

-usually come at very late phase of 3rd trimester but sometimes they come early….even if they present w/preterm contractions only 50% deliver then, the rest the contractions halt

Question 9

How to prevent preterm birth

Answer 9

• progesterone

- cervical cerclage

Question 10

tocolytic agent

Answer 10

• temporarily halt contractions
• but only partially delays for a few days, only given for woman that need a 2 day delay
• Steroids given to mother have positive effect on fetus, this 2 day window form tocolytics is really used just to give the mother steroids (only for preterm)

Question 11

main tocolytic med

Answer 11

indomethacin

Question 12

post-term pregnancy

Answer 12

born at gestational age >42 weeks, higher rate of morbidity and mortality due to insufficient O2/blood

Question 13

oligohydramnios

Answer 13

Too little amniotic fluid
Amniotic fluid produced by kidneys of fetus, removal of fluid is done by fetus swallowing amniotic fluid
PROM also will cause this

Question 14

polyhydramnios

Answer 14

Fetus is producing more urine from the mother having diabetes, decreased fetal swallowing

Question 15

PROM

Answer 15

16-26 weeks (preterm, midtrimester) non-viable

26-37 weeks (prelabor) viable

Question 16

(marginal) placenta previa

Answer 16

presence of placental tissue that extends over or lies at the margin to the internal os

Question 17

total placenta previa

Answer 17

will bleed a lot, it is central

Question 18

any woman over 20 weeks pregnant presenting with painless vaginal bleeding may have

Answer 18

placenta previa, no digital vaginal exam, do transabdominal US first

Question 19

accreta

Answer 19

-placenta adheres to myometrium, leading to difficulty delivering the placenta

Question 20

increta

Answer 20

-placenta invades even deeper into myometrium

Question 21

percreta

Answer 21

-entire myometrium is invaded….WORST

Question 22

MC risk factor for placenta accreta is

Answer 22

previous C-sections

Question 23

placental abruption

Answer 23

placenta detaches before fetus is delivered

Unlike previa, this causes bleeding and PAIN due to contractions

Question 24

abdominal pain with or without bleeding, you should still think of

Answer 24

placental abruption

Question 25

primary and secondary PPH

Answer 25

• occurs within first 24 hours
• 24 hours to 12 weeks after delivery
• Atony is primary cause in primary/secondary-large uterus cannot contract well, leads to massive bleeding