Early Pregancy Problems Flashcards
Date of pregnancy taken from
LMP
Collapsed RIF pain - what is this?
Ectopic pregnancy
Rate of miscarriage
1 in 5
When does failure of most pregnancies occur?
1st Trimester - after this the pregnancy is autonomous and doesn’t require progesterone from the corpus lutetium
Types of miscarriage
Threatened / Inevitable / Incomplete / complete / missed
Diagnosis of miscarriage
Hx - bleeding / Examination - shocked (hypovolaemic - low BP, tachycardiac. Sometimes bradycardiac due to vaginal nerve stimulation), cervical shock, cervical dilation) / Ultrasound / Biochemistry
Complete miscarriage could also be?
Ectopic pregnancy
HCG (Human Chorionic Pregnancy)
Blood - 10 days after fertilisation / Urine - 13 days after fertilisation
Progesterone
Useful marker of non-viable pregnancy. Produced by the corpus leuteum following ovulation
Early pregnancy clinic
Dedicated service with diagnostic tests / Counselling / Follow up and outreach
On uss
Heart beat absent - CRL > 15 mm miscarriage
Management of miscarriage
Conservative - low risk, incomplete > missed, 14 day follow up / Surgical management - Active Management, 2% complication rate / Medical management - Misoprostol (prostaglandin analogue causes contractility), 3 week follow up
What drug can be used to induce miscarriage
Misoprostol - Prostaglandin analogue causing contractility. Causes heavy heavy bleeding for 1 hour
Recurrent miscarriage
3 consecutive, APS, Thrombophilia, fatal chromosomal abnormality
Ectopic definition
Implantation outside of the endometrial cavity. Implantation in the Fallopian tube (ampulla) / tubal pregnancy / history of PID / Presence of IUD when the patient conceives (only if pregnant at the time of implantation)
