Brainscape's Knowledge GenomeTM

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


See full index

Obstetrics and Gynaecology > Early pregnancy > Flashcards

Early pregnancy Flashcards

1
Q

Ectopic pregnancy most common site

A

Fallopian tube

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

Risk factors for ectopic pregnancy

A

Previous ectopic pregnancy
Previous PID
Previous surgery to Fallopian tubes
IUD
Older age
Smoking
PID- previous clamydia infection

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

When do ectopic pregnancies usually present?

A

6-8 weeks gestation

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

Features of ectopic pregnancies

A

Missed period
Constant lower abdominal pain
Vaginal bleeding
Lower abdominal or pelvic tenderness

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

Investigations for ectopic pregnancy

A

Transvaginal ultrasound - ‘blob sign’, ‘bagel sign’, ‘tubal ring sign’

Other features: empty uterus

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

What is PUL? What should you do if this is confirmed?

A

PUL - pregnancy of unknown location.

Track serum hCG over time to monitor PUL. Serum hCG should be repeated in 48 hours.

If rise more than 63% -> likely intrauterine pregnancy. hCG doubles every 48 hours.

If less than 63% after 48 hours -> could indicate ectopic pregnancy

If less than 50% - likely miscarriage.

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

Management options for ectopic pregnancies

A

All ectopic pregnancies should be terminated.

Three options:
- Expectant management (await natural termination)
- Medical
- Surgical

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

Management of ectopic pregnancies with methotrexate

A

Given as IM injection in the buttock and halts progress of pregnancy and results in spontaneous termination.

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

Criteria for surgical management of ectopic pregnancy

A

Pain
Adnexal mass >35mm
Visible heartbeat
HCG >5000

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

Criteria for use of methotrexate management of ectopic pregnancy

A

hCG <5000
Confirmed absence of intrauterine pregnancy on ultrasound.

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

Surgical management option for ectopic pregnancy

A

Laparoscopic salpingectomy (first-line)
Laparoscopic salpingotomy

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

Define missed miscarriage

A

Fetus is no longer alive and no symptoms occured

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

Define threatened miscarriage

A

Vaginal bleeding with closed cervix and foetus that is alive

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

Define inevitable miscarriage

A

vaginal bleeding with open cervix

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

Define incomplete miscarriage

A

retained products of conception remained in the uterus after the miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define complete miscarriage

A

Full miscarriage has occurred with no retained products

17
Q

Define Anembryonic pregnancy

A

a gestational sac is present but contains no embryo

18
Q

Investigations of choice for miscarriage and key features

A

Transvaginal ultrasound is investigation of choice.
Key features:

  • Mean gestational sac diameter
  • Foetal pole and crown-rump length
  • Fetal heartbeat
19
Q

Management of miscarriage under 6 weeks gestation

A

manage expectantly provided they have no pain

repeat urine pregnancy test after 7-10 days and if negative miscarriage confirmed, if not, further investigations is indicated.

20
Q

Management of miscarriage over 6 weeks gestation

A

three options:

  • expectant
  • medical (misopristol)
  • surgical
21
Q

What is medical management of miscarriage?

A

Misopristol - prostaglandin analogue which causes cervix to soften and stimulate uterine contractions.

22
Q

Surgical management of miscarriage? And describe the process.

A

Manual vacuum aspiration and electric vacuum aspiration.

Manual - involved local anaesthetic and involves manual aspiration of contents of uterus

Electric - requires general anaesthetic, cervix widened using dilators and electric powered vacuum removes products of contraception.

23
Q

What is classed as recurrent miscarriage?

A

Three or more consecutive miscarriages

24
Q

When are investigations initiated for recurrent miscarriages?

A

3 or more first trimester miscarriages or one or more second trimester miscarriages

25
Q

Causes of recurrent miscarriages

A

Idiopathic (especially in older women)
Antiphospholipid syndrome
Hereditary thrombophilias
Uterine abnormalities

26
Q

Antiphospholipid syndrome

A

A condition that causes a hyper coagulable state associated with thrombosis and recurrent miscarriages. It can occur on its own or secondary to SLE.

Risk of miscarriage is reduced by low dose aspirin and low molecular weight heparin

27
Q

Most common inherited thrombophilia

A

Factor V leiden

28
Q

Types of uterine abnormalities that can cause recurrent miscarriages

A

Uterine septum
Unicornate uterus
Bicornate uterus
Fibroids

29
Q

Investigations for recurrent miscarriages

A

Antiphospholipid antibodies
Testing for hereditary thrombophilias
Pelvic USS
Genetic testing of the products of conception
Genetic testing on parents

30
Q

Medical abortion treatments

A

Mifepristone (anti-progestogen)
Misoprostol (prostaglandin analogue)

31
Q

MOA of mifepristone

A

Anti-progestogen medication that blocks the action of progesterone, halting the pregnancy and relaxing the cervix

32
Q

MOA of misoprostol

A

prostaglandin analogue, meaning it binds to prostaglandin receptors and activates them. Prostaglandins softens the cervix and stimulate uterine contractions.

33
Q

Complications of medical abortions

A

Bleeding
Pain
Infection
Failure of the abortion
Damage to the cervix, uterus or other structures

34
Q

Diagnosis hyperemesis gravidarum

A

Continuous nausea and vomiting plus:
DEW
Dehydration
Electrolyte imbalance
More than 5% weight loss compared with before pregnancy

unable to keep down anti-emetics

35
Q

Management of hyperemesis gravidarum

A
  1. cyclizine or promethazine
  2. ondansetron or metoclopramide
36
Q

Risk factors of hyperemesis gravidarum

A

Multiple pregnancies
Hyperthyroidism
Nulliparity
Obesity
Trophoblastic disease

Obstetrics and Gynaecology (9 decks)

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