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Reproduction > Early Pregnancy Care > Flashcards

Early Pregnancy Care Flashcards

1
Q

When does the first trimester complete?

A

13 weeks

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2
Q

What are the main complications within the first trimester?

A

Miscarriage
Ectopic pregnancy
Molar pregnancy
Hyperemesis gravidarum

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3
Q

What is the difference between an ectopic and molar pregnancy?

A

Ectopic is an abnormal site of implantation while molar is an abnormal embryo

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4
Q

What is the main symptom of miscarriage?

A

Bleeding

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5
Q

What are the types of miscarriage?

A

Threatened
Incomplete
Complete
Early foetal demise

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6
Q

Give some associated factors for miscarriage

A

Embryonic abnormality
Anti-phospholipid syndrome
Infection
Severe emotional upset

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7
Q

What is thought to be the pathophysiology of miscarriage?

A

Bleeding from placental bed causes hypoxia and placental dysfunction

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8
Q

What is meant by threatened miscarriage?

A

Abnormal pain and bleeding occurring during the pregnancy

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9
Q

What is meant by an inevitable miscarriage?

A

Cervix opens and foetus comes away in the bleeding

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10
Q

What is meant by an incomplete miscarriage?

A

Some of the foetal tissue remains in the uterus

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11
Q

What occurs in a complete miscarriage?

A

All of the foetal tissue has left the uterus

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12
Q

What occurs in an anembryonic pregnancy?

A

A gestational sac develops but the embryo does not form

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13
Q

What investigations can be done for miscarriage?

A

FBC
Group & save
USS
Histology

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14
Q

How many pregnancy losses are required for a recurrent miscarriage?

A

3 or more

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15
Q

What occurs in an ectopic pregnancy?

A

There is implantation outwith the uterus

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16
Q

What is the commonest site of an ectopic pregnancy?

A

Ampulla of fallopian tube

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17
Q

Give some other common sites for ectopic pregnancy

A

Ovary
Peritoneum
Liver
Cervix

18
Q

How does ectopic pregnancy present?

A 
Pain
Dizziness
Collapse
Shoulder tip pain
Pallor
Guarding
19
Q

What are considered red flag signs for ectopic pregnancy?

A

Repeated presentation with abdo/pelvic pain

Pain requiring opiates in a pregnant woman

20
Q

What investigations are done for an ectopic pregnancy?

A

FBC
Group & save
USS

21
Q

How should ectopic pregnancy be managed?

A

Acutely unwell - surgical
Stable/low levels of HCG - medical
Patient “well” - conservative

22
Q

What is the standard treatment for medically managed ectopic pregnancy?

A

Methotrexate

23
Q

What occurs in molar pregnancy?

A

A non-viable fertilised egg implants in the uterus causing an overgrowth of placental tissue

24
Q

How does molar pregnancy appear on ultrasound?

A

Snowstorm appearance

25
Q

What occurs in a complate molar pregnancy?

A

Egg without DNA is fertilised causing paternal diploidy

26
Q

What occurs in a partial molar pregnancy?

A

Haploid egg is fertilised causing triploidy

27
Q

How is a molar pregnancy commonly described?

A

Grape like clusters

28
Q

How is molar pregnancy treated?

A

Surgically

29
Q

What is a chorionic haematoma?

A

Pooling of blood between endometrium and embryo

30
Q

How does a chorionic haematoma present?

A

Threatened miscarriage

31
Q

Give some cervical causes of bleeding in early pregnancy

A

Ectopy
Infections (chlamydia)
Polyps
Malignancy

32
Q

Give some vaginal causes of bleeding in early pregnancy

A

Infections (trichomoniasis)
Malignancy
Ulcers
Forgotten tampon

33
Q

Rhesus positive/negative woman are at higher risk of pregnancy problems

A

Rhesus negative

34
Q

What can be given to Rhesus negative women?

A

Anti-D

35
Q

What occurs in hyperemesis gravidarum?

A

Excessive vomiting in first trimester that alters quality of life

36
Q

Give some features of hyperemesis gravidarum

A

Dehydration
Ketosis
Electrolyte imbalance
Mental health issues

37
Q

Give some principles of management for hyperemesis gravidarum

A

Rehydration
Antiemetics
Nutritional/vitamin support

38
Q

What are the first line antiemetics for hyperemesis gravidarum?

A

Cyclizine

Prochlorperazine

39
Q

What other drugs may be used in hyperemesis gravidarum?

A

Pabrinex
Ranitidine
Omeprazole

40
Q

When may a steroid be used to treat hyperemesis gravidarum?

A

In severe recurrent cases

Reproduction (33 decks)

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