Brainscape's Knowledge GenomeTM

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


See full index

Year 4 Gynae > Early pregnancy complications > Flashcards

Early pregnancy complications Flashcards

1
Q

Common early pregnancy problems

A

Ectopic pregnancy
Miscarriage
Gestational trophoblastic disease
Hyperemesis gravidarum

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

History taking

A 
SQITAR - pain 
Bleeding - when, how much, pads, soaking, colour
Last known menstrual period 
Parity and gravida 
Previous complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Examinations

A

Abdominal - tenderness and scars
Speculum - cervical os open
Bimanual - fibroids

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

Investigations

A

Bloods - folate, FBC, LFTs, HCG, blood group, rhesus status
Abdominal USS
Transvaginal USS
Pregnancy test

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

Threatened miscarriage

A

Bleeding or pain up to 24 weeks of gestation with a viable ongoing pregnancy

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

Inevitable miscarriage

A

Cervix is open

Products of conception have not yet been passed

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

Incomplete miscarriage

A

Cervix is open
Some POC passed
Bleeding and pain persists
Some remaining products of conception identified

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

Complete miscarriage

A

Cervix closed
No products of conception left - empty sac
Bleeding and pain reduced

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

USS classifications

A

Missed miscarriage - no cardiac pulsation
Blighted ovum - empty sac
Incomplete miscarriage - mass within uterus
Complete miscarriage - Empty uterine cavity after previous USS showed mass

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

Pregnancy of unknown location

A

Empty uterine cavity
High HCG
Fetal heartbeat

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

Risk factors for miscarriage

A

Environmental:

  • Smoking
  • Alcohol
  • Advanced age
  • Consanguinity

Fetal abnormality:
- chromosomal

PMHx

  • thyroid diseases
  • PCOS
  • Folate deficiency
  • Previous miscarriage
  • Antiphospholipid syndrome
  • Uterine malformations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management options for miscarriage

A

Expectant
Medical - misoprostol
Surgical - vacuum aspiration

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

When can expectant method of miscarriage be done

A

No fetal HR

Low HCG

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

When can medical method of miscarriage be done

A

No fetal HR

Raised HCG

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

When can surgical method of miscarriage be done

A

Fetal HR present

Raised HCG

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

Advantages of expectant method

A

Natural

Can occur in own home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Disadvantages of expectant method

A

Waiting
Can take up to 2 weeks
Pain, nausea, cramping, bleeding
May be unsuccessful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Advantages of medical method

A

Mimics natural miscarriage

Can be in own home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Disadvantages of medical method

A 
Pain 
Cramping 
Nause 
Vomiting 
May fail and require surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Advantages of the suction curette

A

Quick
Hospital controlled
Can do sterilisation or IUC at same time

21
Q

Disadvantages of the suction curette

A 
Risk of uterine perforation 
Risk of cervical injury 
Risk of haemorrhage 
Risk of pelvic infection 
Asherman's syndrome
22
Q

Definition of recurrent miscarriage

A

Loss of 3 consecutive conceptions with the same partner

23
Q

Differentials for ectopic pregnancy

A

Incomplete miscarriage
Early pregnancy
Gestational trophoblastic disease - molar pregnancy

24
Q

Risk factors for ectopic pregnancy

A 
Previous ectopic 
Asherman's syndrome 
Endometriosis 
STI history/ PID
Tubal surgery 
Tubal pathology
POP/IUCD
25
Q

Ectopic pregnancy presentation

A 
Unilateral pain 
Sudden onset 
Vaginal bleeding 
Fainting/ dizziness 
Shoulder tip pain 
Nausea and vomiting
26
Q

Investigations for ectopic pregnancy

A

Pregnancy test
Bloods - FBC, CRP
TV USS

27
Q

Management of ectopic pregnancy

A

Methotrexate if HCG < 5000

Surgical salpingectomy if HCG > 5000

28
Q

When to do medical management for ectopic pregnancy

A

HCG < 5000
Asymptomatic
Ectopic < 3.5cm
No free fluid on scan

29
Q

When to do surgical management for ectopic pregnancy

A

HCG > 5000
Symptomatic
Ectopic > 3.5cm
Free fluid on scan

30
Q

How long should you avoid conceiving after an ectopic

A

3 - 6 months

31
Q

Follow up for medical mx ectopic

A

1 month follow up for scan and weekly bloods

Wait 3 wks max for pregnancy test to be negative

32
Q

Trophoblastic disease

A

Abnormal fertilisation causing a tissue mass

33
Q

Complete mole

A

empty egg 1 sperm - 46 XX

34
Q

Partial mole

A

egg and 2 sperm - 69 XXY/ XXX

35
Q

Choriocarcinoma

A

Molar pregnancies have the potential to invade or spread which becomes malignant and termed choriocarcinoma

36
Q

Treatment of choriocarcinoma

A

Chemotherapy - methotrexate

37
Q

Symptoms and signs of molar pregnancy

A 
Bleeding 
Hyperemesis 
Large for dates
Very high beta HCG levels 
HTN
38
Q

Investigations for molar pregnancy

A 
Pregnancy test 
BP 
Bloods - HCG, FBC, TSH, Group and save 
TV USS 
Histology
39
Q

USS appearance of molar pregnancy

A

Snowstorm appearance

40
Q

Management of molar pregnancy

A

Surgical curettage + histology
Notify trophoblastic screening centre
Follow up pregnancy test after 3 weeks
Follow up of serum and urine HCG levels

41
Q

Hyperemesis gravidarum

A

Excessive nausea and vomiting in early pregnancy

42
Q

Symptoms of hyperemesis gravidarum

A 
Severe dehydration 
Deranged bloods 
MArked ketosis 
Weight loss 
Nutritional deficiency
43
Q

Risk factors

A 
Twins 
Trophoblastic disease
Hyperthyroidism
Nulliparity
Obesity
44
Q

Complication of hyperemesis gravidarum

A

Can be associated with thyrotoxicosis

45
Q

Differentials for hyperemesis gravidarum

A 
Molar pregnancy 
Normal nausea of pregnancy 
UTI 
Gastroenteritis 
Appendicitis 
Thyrotoxicosis
46
Q

Investigations for hyperemesis gravidarum

A 
Basic observations 
Abdominal examination 
Bloods - FBC, TSH, LFTs, U+Es, HCG
Urine sample - ketones
TV USS
47
Q

Treatment of hyperemesis gravidarum

A

IV fluids
Thiamine and folic acid - as not eating
Antiemetic
Consider thromboprophylaxis if dehydrated

48
Q

Red flags of hyperemesis gravidarum

A

Weight loss
Long period of not eating
Dizziness
Reduced fetal movements

49
Q

How does smoking affect hyperemesis gravidarum

A

Decreases risk

Year 4 Gynae (35 decks)

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