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Women's health trigger > Complications of pregnancy trigger > Flashcards

Complications of pregnancy trigger Flashcards

1
Q

risk factors include STD, PIC and IUDs

A

ectopic pregnancy

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2
Q

presents with vaginal bleeding, adnexal mass, abdominal pain and tenderness on the pelvic exam. what is your assumed diagnosis and what other presentations could you see?

A

ectopic pregnancy

could see hypotension, unresponsive, peritoneal irritation radiating up to R shoulder referral.

would also see bHCG that does not increase 2x every 48 hrs and an US that shows an empty uterus or a donut sign.

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3
Q

pt presents with vaginal bleeding. BP is 86/48 and she is currently unresponsive. on the way to the ER EMS reports pt complaining of pelvic pain radiating to the Right shoulder.

what is the diagnosis and what diagnostics would you get to confirm

A

ectopic pregnancy

b-hCG does not 2x every 48h as it does normally
U/S: Empty uterus or donut sign

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4
Q

US showing donut sign

A

ectopic pregnancy

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5
Q

bone marrow depression is a SE of what

A

Methotrexate usage

also see:
stomatitis
liver
gastroenteritis
seperation pain

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6
Q

which surgery is a complete tubal resection

A

salpingectomy

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7
Q

which surgery is a removal of ectopic pregnancy while salvaging tubes

A

salpingostomy

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8
Q

which abortion type presents with an open cervical os and a pregnancy that is unlikely to be viable but is NOT treated with a D&C

A

inevitable abortion

dont D&C because there is still a small tiny possibility that baby could make it

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9
Q

Death prior to 20 weeks with complete retnetion of POC and a closed cervical os

A

missed abortion

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10
Q

a 16 week pregant patient presents with complaints of vaginal spotting. on pelvic exam her cervical os is closed. ultrasound shows a viable pregnancy. what is the diagnosis

A

threatened abortion

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11
Q

an excessively edematous immature placenta is a indication of what

A

molar pregnancy (hydratiform mole)

also see:
villous stromal edema
trophoblast proliferation

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12
Q

a risk factor for this condition is extremes of reproductive age. including very young OR very old women

A

molar pregnancy

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13
Q

a patient presents with vaginal bleeding with reports of a positive pregnancy test last week. she has yet to visit her OBGYN but suggests that she is likely only 4 weeks pregnant. lab studies show a hCG of 127,000 and US shows a mass with multiple cystic spaces that seems to be the size of a 12 week old fetus.

what is likely the diagnosis and what is the pathology behind this?

A

complete molar pregnancy

46 XX or XY
Paternal in origin for both sets
Vag bleeding
Large for date
hCG > 100k
Theca lutein cyst
NO fetal parts with edematous villi

US shows snowstorm appearance (anechoic cystic spaces)

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14
Q

theca lutein cyst is associated with which condition

A

complete molar pregnancy

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15
Q

a patient presents with vagnial bleeding and reports she might be pregnant but is not sure. HCG is 18,000 and ultrasound shows a multicystic placenta that is thickened. what is the likely diagnosis and what are the key points.

A

partial molar pregnancy

69 XXX or XXY or XYY
Two paternal haploid and 1 maternal
Missed abortion + small for date
Fetal parts present

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16
Q

what is the confirmatory diagnostic for molar pregnancies

A

pathology

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17
Q

this can result in thyroid storm and increased risk of hyperemesis gravidarum and preeclampsia/eclampsia.

A

molar pregnancies

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18
Q

Bleeding occurring with a viable mature fetus after week 24

A

antepartum bleeding

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19
Q

what complication of pregnancy may be assocaited with an elevated AFP (not fetal complication, pregnancy complication)

A

placental abruption

rememberthe FETAL complication that occurs with elevated AFP is neural tube defects:)

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20
Q

this is a diagnosis of exclusion

A

placental abruption

21
Q

complications of this include consumptive coagulopathy and couvelaire uterus

A

placental abruption

can also see AKI and hypovolemic shock.

22
Q

If a mother has placental abruption and they are in hypovolemic shock what is the management

A

crystalloid and blood transfusion (PRBCs)

general placental abruption management:
if fetus is alive -> c section
if fetus is dead -> vaginal (im assuming c section if shes in hypovolemic shock tho??)

23
Q

what is the definition of a low lying placenta

A

2cm outside of os

24
Q

risk factors for this pregnancy complication includes prior c section, smoking and elevated MSAFP

A

placenta previa

also:
increased age
increased parity

25
Q

Painless vaginal bleeding occurring past 2nd trimester is indicative of what

A

placenta previa

26
Q

when is digital exam contraindicated

A

placenta previa because you could puncture the placenta

27
Q

Abnormally firm adherence to myometrium due to lack/thin decidua basalis and imperfect fibrinoid layer.

A

placenta accrete syndromes

28
Q

having placenta previa puts increases the risk of what other complication

A

placenta accrete syndromes

29
Q

what confirms placental accrete syndromes

A

pathology

30
Q

Painless cervical dilatation in 2nd trimester

A

cervical insufficiency

31
Q

a risk factor for this complication is DES exposure

A

cervical insufficiency!

also prior cervical trauma is a risk factor

32
Q

what complication of pregnancy requires a swab for infection at time of diagnosis

A

cervical insufficiency

33
Q

if a mom has a previous hx of premature births, what should you give her

A

IM progesterone

34
Q

if mom has a shortened cervix and youre looking to prevent premature birth, what do you do

A

vaginal progesterone

35
Q

membrane rupture BEFORE contractions begin AND before 37 weeks is known as what

A

PPROM

36
Q

risk factors include smoking, antepartum bleeding and genital tract infection

A

PPROM

37
Q

what complication is treated with ABX therapy + tocolysis + corticosteroids? what are the ABX combo options?

A

PPROM

  • Ampicillin IV then amoxicillin PO
  • Erythromycin IV then erythromycin PO
  • Erythromycin IV then azithromycin PO
38
Q

what complication of PPROM means we must immediately deliver? when do we typically want to wait to deliver PPROM babies?

A

clinical chorioamnionitis (infection) = deliver

typically try to wait until 34 weeks.

39
Q

what is the MOST dangerous complication of PPROM

A

cord prolapse

40
Q

What other conditions can occur in place of proteinuria to qualify for preeclampsia?

A

Thrombocytopenia
Renal insufficiency
Impaired liver function
Pulmonary edema
New onset HA unresponsive to therapy

41
Q

what is HELLP and what does it suggest?

A

Hemolysis, elevated liver enzymes, lower platelets.

suggests preeclampsia superimposed on chronic HTN

42
Q

proteinuria + new onset HTN after 20 weeks

A

preeclampsia

43
Q

complications of neonates born to mothers with this pregnancy complication include:
hypocalcemia
cardiomyopathy
hyperbilirubinemia and polycyhemia
hypoglycemia

A

pregestational diabetes

also:
RDS and long term cognitive defects

44
Q

what type of management is preferred in pregestational DM

A

insulin instead of orals

45
Q

a t sign on an ultrasound suggests what

A

monochorionic shared placenta

46
Q

a twin peak sign on an ultrasound suggests what

A

fused dichorionic placenta

47
Q

what is the GABA A receptor modulator that was made for PPD onset in the 3rd trimester

A

Zuranolone

48
Q

when should we order an echo in prenatal complications

A

chronic long term HTN

49
Q

when should you consider pre-op uterine artery embolization or leaving the placenta in situ until a future hysterectomy

A

placenta accrete syndrome

Women's health trigger (23 decks)

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