Early Pregnancy Flashcards
What are important symptoms to ask about when a woman presents with vaginal bleeding in early pregnancy?
Dizziness, shoulder tip pain
What examination is done on women in early pregnancy with bleeding?
General inspection
Abdominal exam
Speculum exam to look if internal os is open or not
Binmanual examination (assess uterus size)
After how many weeks can transabdominal USS be used?
Over 8 weeks gestation can use abdo USS but if image unclear may need to do transvaginal USS
If b-HCG levels do not rise adequately on serial measurements what could this mean?
An intrauterine pregnancy is not developing properly or an ectopic
What is a threatened miscarriage?
Bleeding and pain up to 24 weeks with a viable ongoing pregnancy
What is an inevitable miscarriage?
Internal os is open , products of conception have not been passed, but inevitably will be
What is an incomplete miscarriage?
Where one products of conception have been passed but some tissues and blood remain in the uterus, cervix stays open
How is a septic miscarriage managed?
24 hours of IV antibiotics then surgical removed of retained tissue
What is a missed miscarriage?
The fetus is no longer alive but no symptoms have occurred
What are risk factors for ectopic pregnancy?
prev. Ectopic, tubal surgery or pathology, PID or endometriosis, POP, pregnancy with copper coil
When would expectant management for ectopic pregnancy be offered?
Asymptomatic, no rupture, <3cm, low HCG <1500 and falling
What is the criteria for medical management of an ectopic pregnancy?
<3.5 cm in size, b-HCG<5000, no free fluid
What is the medical management of ectopic pregnancy?
Methotrexate
What are the different types of hydatidiform mole?
Complete mole (empty egg, 1 sperm)
Partial mole (1 egg, 2 sperm)
What would a snowstorm appearance on ultrasound scan suggest?
Molar pregnancy
