Complications Seen in Early Pregnancy Flashcards
MC site ectopic preg
ampulla of FT
What is a heterotopic pregnancy
one normal and one ectopic pregnancy
How does ectopic preg presents?
unilateral abd pain +/- vaginal bleeding
What are RF for developic ectopic preg
prior ectopic
tubal scarring (STI/PID)
assisted fertility
endometriosis
What is the incidence of ectopics
1:100 pregnancies
You suspect ectopic, next step?
if hCG + get US to confirl extra-uterine preg,
if not ruptures, tx is MTX – recheck hCG levels in 4-7 days, should fall by >15% (if not, repeat course MTX)
First trimester bleeding, think…
ectopic and spontaneous Ab
For the following: Cervix open or closed? where are products of conception? management?
- complete abortion
- threatened abortion
- incomplete abortion
- inevitable abortion
- missed abortion
- complete abortion: cervix closed, all products have been passed, no further steps necessary
- threatened abortion: closed cervix, products are still inside uterus, expectant management
** for the following need D&C , prostaglandins or allow process to finish on its own:
- incomplete abortion: open cervix, some expelled and some remain
- inevitable abortion: cervix is open but products remain
- missed abortion: closed cervix with products still inside uterus w/o heart beat
Causes of 2nd trimester bleeding?
anatomic defects (MCC) –> sp abortion
infection
maternal disease
fetotoxic agents
what is defn of incompetent cervix? MCC?
painless dilation and effacement before term
surgery or trauma > uterine abnormalities
Management for incopetent cervix?
< 24 wks (not viable) –> emergent cerclage
> 24 wks (viable) –> betamethasone and strict bed rest
history of incopetent cervix? next step when preg again
offer elective cerclage at 12-14 wks
complications of cerculage
ROM, PTL, infx
What is the McDonald vs Shirokar cerclage?
Mcdonald = closure at external os Shirokar = at internal os
Defn of recurrent pregnancy loss
3+ consecutive SAbs
