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reproduction > complications of pregnancy > Flashcards

complications of pregnancy Flashcards

1
Q

what is miscarriage ?

A

loss of pregnancy before 24 weeks

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2
Q

what is the incidence of spontaneous miscarriage ?

A

15%

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3
Q

what are the different types of miscarriage ?

A 
threatened
inevitable
incomplete
complete
septic
missed
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4
Q

what is a threatened miscarriage ?

A

vaginal bleeding +/- pain
viable pregnancy
closed cervix on speculum exam

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5
Q

what is an inevitable miscarriage ?

A

open cervix with bleeding

bleeding heavy +/- clots

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6
Q

what is a missed miscarriage ?

A

no symptoms, could have bleeding

gestational sac seen on scan, no fetus or fetal pole

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7
Q

what is an incomplete miscarriage ?

A

most of pregnancy expelled, some products may remain
open cervix
vaginal bleeding may be heavy

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8
Q

what is complete miscarriage ?

A

passed all products of conception
cervix closed
bleeding stopped

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9
Q

when do you get septic miscarriage ?

A

cases of incomplete miscarriage

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10
Q

what is the aetiology of spontaneous miscarriage ?

A

abnormal conceptus - chromosomal, genetic, structural
uterine abnormality - congenital, fibroids
cervical incompetence
maternal - increased age, DM

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11
Q

how do you manage miscarriage ?

A

threatened - conservative
inevitable - if heavy bleeding may need evacuation
missed - prostaglandin, surgical

septic - Abx and evacuate uterus

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12
Q

what is the most common site for ectopic pregnancy ?

A

ampullarf section of fallopian tube

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13
Q

what are risk factors for ectopic pregnancies ?

A

pelvic inflammatory disease
previous tubal surgery
previous ectopic
assisted conception

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14
Q

how do ectopic pregnancies present ?

A

period of amenorrhoea, +ve urine test
vaginal bleeding
abdominal pain
GI/urinary symptoms

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15
Q

how do you investigate ectopic pregnancy ?

A

serum B-hCG levels
USS - no intrauterine gestational sac, adnexal mass, fluid in pouch of Douglas
serum progesterone - if IU pregnancy may be high

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16
Q

how do you manage ectopic pregnancy ?

A

methotrexate

surgical - salphnectomy

17
Q

what is antepartum haemorrhage ?

A

haemorrhage from genital tract after 24th week but before delivery

18
Q

what causes antepartum haemorrhage ?

A 
placenta praevia
placental abruption
APH of unknown origin
local lesions of the genital tract
vasa praevia - bad, small volume of blood from fetal vessel rupture
19
Q

what is placenta praaevia ?

A

all or part of the placenta implants in the lower uterine segment

20
Q

what are risk factors for placenta praaevia ?

A

multiparous women
multiple pregnancies
previous Caesarean section

21
Q

what are the classifications of placenta praaevia ?

A

grade 1 - placenta encroaching on lower segment but not internal os
grade 2 - placenta reaches internal os
grade 3 - placental eccentrically covers os
grade 4 - central placenta praaevia

22
Q

how does placenta praevia present ?

A

painless PV bleeding
malpresentation of fetus
soft non-tender uterus

23
Q

how do you investigate placenta praaevia ?

A

USS

DO NOT DO VAGINAL EXAM

24
Q

how do you manage placenta praaevia ?

A

gestation

Caesarean section

25
Q

what is a maternal complication of placenta praaevia ?

A

post partum haemorrhage

26
Q

how do you manage post partum haemorrhage ?

A

medical - oxytocin, ergometrine, carbaprost, tranexamic acid

balloon tamponade
surgical ligation of vessels
hysterectomy

27
Q

what are factors associated with placental abruption ?

A 
pre-eclampsia/chronic hypertension
multiple pregnancy
polyhydramnios
smoking, increased age, parity
previous abruption
cocaine use
28
Q

what are the three types of placental abruption ?

A

revealed
concealed
mixed

29
Q

what is the presentation of placental abruption ?

A

pain ++
vaginal bleeding
increased uterine activity

30
Q

what are complications of placental abruption ?

A

maternal shock, collapse
fetal death
maternal DIC, renal failure
postpartum haemorrhage

31
Q

what are predisposing factors to preterm labour ?

A 
multiple pregnancy
polyhydramnios
APH
pre-eclampsia
infection - UTI
prelabour premature membrane rupture
32
Q

what are neonatal morbidities resulting from prematurity ?

A 
RDS
intraventricular haemorrhage
cerebral palsy
nutrition 
temperature control
jaundice
infections
visual impairment
hearing loss

reproduction (26 decks)

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