Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Case 31 - Concerns During Pregnancy 2 > Early and Late Complications of Pregnancy > Flashcards

Early and Late Complications of Pregnancy Flashcards

1
Q

What is Hyperemesis Gravidarum?

A

it is extreme, persistent nausea and vomiting during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what can Hyperemesis Gravidarum lead to in pregnant women?

1)
2)
3)

A

It can lead to;

dehydration

weight loss

electrolyte imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is morning sickness?

A

mild nausea and vomiting that occurs in early pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the most common time period morning sickness occurs?

A

Most common during the first 3 months of the pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

causes of moring sickness

A

not fully understood

potentially caused by rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is HCG released by?

A

released by the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what pregnancies are considered high risk to developing Hyperemesis Gravidarum?

1)
2)
3)
4)

A

in twin pregnancies

molar pregnancies

hyperemesis in previous pregnancies

motion sickness history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hyperemesis Gravidarum management plan?

1)
2)
3)
4)

A

Hydration

Antiemetics

Multivitamin supplements

severe cases - steroid use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hyperemesis Gravidarum can cause weight loss of more than 5% of body weight. True or False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bleeding in early pregnancy causes (5)

A

Implantation bleeding ( physiological)

Miscarriage

Ectopic Pregnancy

Cervical causes – Ectropion/polyp, rarely cancer

Molar pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

define miscarriage?

A

miscarriage is the loss of a pregnancy during the first 22 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

list 5 causes of miscarriage?

A

Unknown

Chromosomal

Placental problems

Uterine anomalies

Cervical incompetence

Autoimmune conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of pregnancies end in miscarriage?

A

15% (1 in 8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

miscarriage signs and symptoms and what you’ll find on examination?

A 
Signs
normal observations
tachycardia
low BP
tender on abdominal examination (in suprapubic area)

Symptoms
Vaginal bleeding
Cramping + pain in lower abdomen

On Examination
Bleeding from the cervical os.
Cervical os can be open or closed
Products of conceptions might be seen on examination.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the types of Miscarriage

A

Threatened miscarriage -> pregnancy remains viable

Inevitable miscarriage

Incomplete miscarriage -> Products of conception partly expelled

Completed miscarriage ->Products of conception completely expelled

Missed miscarriage -> non-viable pregnancy

- Septic miscarriage
- Recurrent miscarriage -> three or more consecutive miscarriages (1%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what reduces the chances of miscarriage?

A

abstain from

Alcohol

Smoking

illegal drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Can long term health conditions impact pregnancies? if yes then how?

A

yes

Several long-term (chronic) health conditions can increase the risk of having a miscarriage in the second trimester especially if they’re not treated or well controlled

e.g diabetes, high blood pressure, lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is a miscarriage diagnosed?

A

Early pregnancy
USS ( transvaginal)
blood test for HCG

Ultrasound?
Checking for foetus heartbeat?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is a miscarriage managed?

A

Medications used
Mifepristone ( Anti progesterone ) and Misoprostal ( potent uterine stimulant) tablets

Surgical
Evacuation of the uterus by suction evacuation/ curettage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does Resus Negative blood group mean?

A

???????

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If the woman blood group is Rh-ve what is she administered?

A

Anti–D is administered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why is Anti –D administered to women with the blood group Rh-ve?

A

prevents haemolytic disease of the foetus and newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is an Ectopic Pregnancy?

A

when a fertilised egg implants outside of the uterus, usually in one of the fallopian tubes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the Risk of ectopic pregnancy in UK?

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the symptoms of an ectopic pregnancy?

A

Positive pregnancy test and othersigns of pregnancy

Lower abdominal pain, more on one side/localised

Vaginal bleedingor a brown watery discharge

Shoulder tip pain

Discomfort while micturating or opening bowels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are investigations and management for an ectopic pregnancy?

A

Investigations:
USS and blood test ( FBC and B-HCG)

Management:
Medical management with Methotrexate
Surgical management with salpingectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

is missing an ectopic pregnancy dangerous?

A

yes - if missed or not managed appropriately can be life threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Miscarrige VS Ectopic pregnancy differences

A

Miscarriage Ectopic

Pregnancy WITHIN the uterine cavity Pregnancy OUTSIDE the uterine cavity

Pain is more in the suprapubic area Pain localized to one side

Bleeding can be moderate to heavy Bleeding is minimal

Pregnancy can continue and it’s safe Continuing pregnancy is unsafe

No adnexal tenderness on examination Adnexal tenderness positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is a Hydatiform mole?

A

A hydatidiform mole is a growing mass of tissue inside your womb (uterus) that will not develop into a baby.
It may cause bleeding in early pregnancy and is usually picked up in an early pregnancy ultrasound scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are Hydatiform mole pregnancy symptoms?

A

nausea and vomiting can be occasionally profound

31
Q

how is Hydatiform mole pregnancy diagnosed and confirmed?

how is it treated?

A

Diagnosis: USS and high levels of beta- HCG
Confirmed by histology

Treatment: surgical evacuation
Notify molar pregnancy register

Biochemical follow up – till B HCG is negative
Avoid COCP as it delays the return of B- HCG

32
Q

basic causes of abdominal pain?

A 
Heart burn
Constipation
Musculo- Skeletal
Appendicities
Cholecystitis
Renal colic
IBS
Ovarian cyst accidents
33
Q

what are the physiological changes in pregnancy in the urogenital tract?

A

Bladder volume increases and detrusor tone decreases.

Ureteric dilatation due to combination of progestogenic relaxation of ureteric smooth muscle and pressure from the expanding uterus.

Relative sparing of the left ureter because of protection from the sigmoid colon and upper rectum.

The net effect - is increased urinary stasis, compromised ureteric valves and vesicoureteric reflux.

Facilitates bacterial colonisation and ascending infection

34
Q

are UTI’s common in pregnancy?

are they asymptomatic or symptomatic?

how is it diagnosed?

A

yes

can be either

Mid stream sample (MSU) is sent for culture and sensitivity (C/S) at booking

35
Q

In pregnancy -the overall incidence of UTI is approximately…….%

The incidence of asymptomatic bacteriuria in pregnant women is ……%

Escherichia coli accounts for ——–% of infections

A

…..8%

……2-5%

……80-90%

36
Q

what is Asymptomatic Bacteriuria associated with?

A

Preterm delivery and low birthweight

Increased risks of preeclampsia

Anaemia

Chorioamnionitis

Postpartum endometritis

Fetal growth restriction

37
Q

Asymptomatic Bacteriuria treatment?

A

appropriate antibiotics for 7 days based on C/S

38
Q

what are the symptoms and treatment for Acute Cystities?

A

Symptoms: are dysuria, frequency, urgency and suprapubic pain in the absence of systemic illness.

Treatment is hydration and antibiotics

39
Q

what % of women does acute cystitis affect?

A

Affects approximately 1% of all pregnant women.

40
Q

what % of women with asymptomatic bacteriuria develop acute cystitis during their pregnancy.

A

30% of women

41
Q

what is Pyelonephritis?

how serious is in in pregnancy?

A

is an infection of a renal papilla, which if untreated can spread to multiple papillae and occasionally to the renal cortex

Serious type of urinary infection in pregnancy

42
Q

what are the symptoms, investigations and treatment for Pyelonephritis in pregnancy?

A

Symptoms:
sepsis ( tachycardia, tachyapnoea, pyrexia)
loin pain
urinary symptoms

Investigation: 
MSU,USS of the renal tract, 
FBC
Renal function tests
blood culture
CRP

Treatment: Antibiotics for 10-14 days.

43
Q

when do most of the cases of pyelonephritis occur during pregnancy?

A

last two trimesters

44
Q

what are the risks of developing Recurrent Urinary Tract infection during pregnancy?

A

The risks of developing pyelonephritis and its potential consequences are the same as for the primary infection.

45
Q

what is the treatment for Recurrent Urinary Tract infection during pregnancy?

A

Long-term, low dose antimicrobial cover or single postcoital doses for the remainder of the pregnancy.

46
Q

what is anaemia?

A

Anaemia is having lower than normal Haemoglobin.

47
Q

what are the Haemoglobin cut offs in each trimester before being considered anaemic?

A

1st and 2nd trimester – minimum of 110g/dl

3rd trimester it is 105g/dl

48
Q

what are the symptoms of anaemia during pregnancy?

what are the investigations and treatment?

A

Symptoms:
Feeling tired and exhausted
Palpitations
Breatlessness

Investigation: FBC, Ferritin, Folic acid and Vit B12 levels

Treatment:
oral /injectable iron
&/or Vit B12
&/or Folic acid

49
Q

what is Antepartum Haemorrhage?

A

Is defined as bleeding from the genital tract after the 22nd week of pregnancy

Extras
Complicates 2-5% of all pregnancies.
Associated with fetal and maternal morbidity and mortality.

50
Q

what are the causes of Antepartum Haemorrhage?

A 
placental abruption
placenta previa
vasa previa
cervicitis
trauma
vulvo-vaginal varicosities
genital tumors 
infection
51
Q

what is the management for Antepartum Haemorrhage?

A

Depends on the cause, severity and gestational weeks

Admit to hospital
Cannula and take bloods (FBC, G&S U&Es coagulation profile)
Resuscitation (iv fluids, blood transfusion)
Examination
Ultrasound

Rh –ve women needs anti D and Kleihauer test

52
Q

define Placenta Praevia?

A

Defined as Placenta partly or completely inserted in the lower uterine segment

53
Q

define and explain the different grades of placenta pravia?

A

insert picture????????????????

54
Q

define placental abruption

A

It is bleeding following premature separation of normally situated placenta

it can be Revealed or concealed??

55
Q

what are the causes of placental abruption?

A

Majority of the cases the cause is unknown
trauma
polyhydramnios
hypertension

56
Q

define placental abruption diagnosis and management

A

Diagnosis – clinical presentation and examination, ultrasound

Management depends on severity, gestational age, maternal and fetal condition

57
Q

define preterm labour

A

the onset of labour before 37 completed weeks of gestation

58
Q

list pre-term labour risk factors

A

Multiple pregnancies

History of preterm labour

Polyhydramnios

Infectio

59
Q

explain how pre-term labour diagnosis takes place

A

Diagnosis on clinical grounds, fetal fibronectin test and ultrasound

60
Q

what is metal fibronectin (fFN)

A

it is a fibronectin protein produced by foetal cells.

It is found at the interface of the chorion and the decidua (between the foetal sac and the uterine lining).

It is like an adhesive/ biological glue that binds the foetal sac to the uterine lining.

61
Q

how is pre-term labour managed?

A

Tocolysis – to slow labour for administration of steroids and in-utero transfer if needed

Steroids – for fetal lung maturation

Magnesium sulphate- for neuro protection till 34 weeks of gestation

62
Q

define Preterm Pre-labour rupture of membranes (PPROM)

who is more at risk of PPROM?

A

Spontaneous rupture of membranes before 37 weeks of gestation in the absence of regular painful uterine contractions.

Polyhydramnios
previous history of PPROM
uterine anomalies
infections

63
Q

what is the diagnosis and management of Preterm Pre-labour rupture of membranes (PPROM)

A

Diagnosis
Examination swabs
USS

Management 
tocolysis
antibiotics
steroids
delivery
64
Q

Define Intra uterine growth Retardation (IUGR)

A

Failure of the foetus to achieve the expected weight for a given gestational age

65
Q

define small for gestational age (SGA)

how is it diagnosed and managed

A

Refers to fetus estimated birth weight (EFW) on USS is below the 10th centile for the given population.

SGA : Constitutionally small or growth restricted.

Diagnosis: Regular SFH, use of customized growth charts, USS

Management: careful monitoring and appropriate intervention .

66
Q

intra uterine growth retardation causes

A

chromosomal

uteroplacental

environmental

67
Q

define Obstetric Choestasis

A

It is a multifactorial condition of pregnancy characterised by pruritus in the absence of a skin rash with abnormal liver function tests (LFTs),neither of which has an alternative cause and both of which resolve after birth.

68
Q

Explain what the diagnosis, complications and treatment of Obstetric Choestasis are

A

Diagnosis:
unexplained pruritus and abnormal liver function tests (LFTs) and/or raised bile acids occur in the pregnant woman and both resolve after delivery.
usually involves palms and soles of the feet
Postnatal resolution of symptoms and of biochemical abnormalities is required to secure the diagnosis.
LFTS should be deferred 10 days following delivery

Complications:
meconium passage, small risk of stillbirth, premature birth (iatrogenic)

Treatment:
symptomatic management

69
Q

what is pre-eclampsia?

A

Pre-eclampsia is a condition that typically occurs after 20 weeks of pregnancy. (6%)

It is a combination of raised blood pressure (hypertension) and protein in urine (proteinuria)

70
Q

what are the symptoms of pre-ecalmpsia?

A

asymptomatic

headaches

visual disturbance

pain the right hypochondriac region

edema

71
Q

what are the risk factors of pre-ecalmpsia?

A

diabetes

high blood pressure orkidney disease before starting pregnancy

lupus or antiphospholipid syndrome

personnel or FH of pre-eclampsia

1st pregnancy

maternal age more than 40

High BMI

PCOS

multiple pregnancies

72
Q

how is pre-eclampsia diagnosed and investigated?

A

The earlier the pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby.

Investigations:
Bloods for FBC, U and Es
Uric acid
coagulation profile
fetal monitoring
urine ACR
73
Q

how is pre-eclampsia monitored?

what are the complications?

A

Management
Regular BP monitoring and anti hypertensives
Fetal growth monitoring
Delivery

Complication
Eclampsia- seizures – Magnesium sulphate 
Intracranial Haemorrhage 
Pulmonary edema
HELLP syndrome
Placental abruption
Stillbirth
IUGR
74
Q

why should caution be maintained when prescribing NSAID’s for pregnant women during the third trimester?

A

NSAIDs – in third trimester can lead to premature closure of ductus arteriosus)

Case 31 - Concerns During Pregnancy 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions