Early Pregnancy Flashcards
How does a molar pregnancy present on USS?
Appears like a ‘snowstorm’.
When is it determined that someone is pregnant?
Period missed
Positive pregnancy test
Is light bleeding normal in early pregnancy?
Yes - called spotting.
Will self resolve.
What are the 4 potential outcomes following fertilisation?
Birth
Miscarriage
Ectopic pregnancy
Molar pregnancy
What are symptoms of miscarriage?
Positive pregnancy test
Bleeding (heavy)
USS showing expulsion/empty uterus
How can the cervical os present upon speculum exam?
Os open = Inevitable miscarriage.
Os closed = Threat to pregnancy.
Os closed, products in vagina = Miscarriage has occurred.
When does cervical shock occur?
When products are sitting at, and causing dilatation of, the cervical os.
How is cervical shock treated?
IV infusion
Uretonics
What does a threatened miscarriage mean?
Risk to pregnancy.
What does an inevitable miscarriage mean?
Pregnancy cannot be saved.
What does an incomplete miscarriage mean?
Part of the pregnancy is lost.
What does a complete miscarriage mean?
All of the embryo is lost - the uterus is empty.
What is a missed miscarriage?
The absence of a foetus within the sac - said to be anembryonic.
What is recurrent miscarriage?
3 or more lost pregnancies.
Which condition is linked to recurrent miscarriage?
Antiphospholipid syndrome
What is ectopic pregnancy?
When a normal embryo implants outwith the uterine cavity.
Where is the most common site of ectopic pregnancy?
Fallopian tubes
Repeated presentation of a women of reproductive age with severe abdominal/pelvic pain is a red flag for what condition?
Ectopic pregnancy
What must be carried out on suspicion of an ectopic pregnancy?
Pregnancy test
Transvaginal USS
FBC
How is ectopic pregnancy treated?
If stable, treat with methotrexate.
If acutely unwell, remove surgically.
How does a pregnancy of unknown location present?
Amenorrhoea
Abdominal pain
Positive pregnancy test
No evidence of pregnancy in genital tract or abdominal cavity upon USS
How is a pregnancy of unknown location treated?
Treat with methotrexate.
What is a molar pregnancy?
Disease producing a non-viable, fertilised egg. There is overgrowth of placental tissue - appears like grapes.
What is a complete mole?
Egg contains no DNA from mother
1 or 2 sperm fertilise the egg
No foetus
What is a partial mole?
Haploid egg
1 or 2 sperm fertilise the egg
May have foetus
What is the common presentation between a complete and partial mole?
Overgrowth of placental tissue.
How does molar pregnancy present?
Hyperemesis
Early onset pre-eclampsia
Hyperthyroidism
Enlarged uterine fundus on palpation
How is molar pregnancy diagnosed?
USS
What is a chorionic haematoma?
A pooling of blood between the endometrium and embryo due to separation.
Threat of miscarriage.
What is a risk of giving antibiotic therapy for an STI/UTI in a pregnant individual?
Risk of teratogenicity.
In those treated with surgery for ectopic/molar pregnancy, what is given?
Anti-D treatment
When is the first USS usually carried out?
12 weeks
What is the role of anti-D injection?
Aims to neutralise anti-D antigen, preventing sensitisation of the immune system to it.
If antibodies form against this, they can terminate pregnancy.
What is hyperemesis gravidarum?
Excessive, protracted vomiting that affects quality of life in the 1st trimester.
A normal sign of pregnancy that is intensified.
How is hyperemesis gravidarum treated?
Exclude other causes Rehydrate Give parenteral antiemetics Vitamin supplementation DVT prophylaxis Thiamine supplementation H2 blockers Proton pump inhibitors
What are the first-line antiemetics in pregnancy?
Cyclizine
Prochlorperazine
