Early Pregnancy Complications Flashcards
What are the symptoms of a miscarriage?
bleeding
cramping
positive UPT
What can cause a miscarriage?
embryonic abnormality severe emotional distress/upset infections: CMV/Rubella/toxoplasmosis/listerosis iatrogenic after CVS heavy smoking, cocaine or alcohol misuse uncontrolled diabetes
What is the rough pathogenesis of a miscarriage?
bleeding from placental bed or chorion causing hypoxia and vilious/placental dysfunction
causes embryonic demise
How is a miscarriage investigated?
USS will confirm pregnancy in situe
speculum exam will show the status of the cervix
What are the different status’ of the cervix in relation to miscarriage?
closed = threatened
closing = complete
products are sited at an open cervical os = inevitable
What is cervical shock?
cramps, nausea/vomiting, sweating, fainting
How is cervical shock treated?
resolves when products are removed
IV fluids
What are the types of miscarriage?
threatened = risk to pregnancy
inevitable = pregnancy cant be saved
incomplete = part of the pregnancy already lost
complete = all of the pregnancy lost, uterus is empty
early foetal demise = pregnancy in situ but no heart beat
anembryonic pregnancy = no foetus, empty sac
What are the management options for miscarriage?
conservative
medical (misoprostol)
MVA/surgical
What is recurrent miscarriages?
3 or more pregnancies lost
What do you look for in recurrent miscarriages?
Antiphospholipid syndrome thrombophillia balanced translocation uterine abnormality uterine natural killer cells
How can thrombophillia or APS be treated?
daily fragmin injections or low dose aspirin
What may a progesterone vaginal pessentery be used for?
to minimise pregnancy loss
What is the definition of an ectopic pregnancy?
implantation outwith the uterine cavity
What are the sites that an ectopic pregnancy can occur?
fallopian tube - most common ovary peritoneum liver cervix c-section scar
What is the presentation of an ectopic pregnancy?
pain - no1 symptom bleeing dizziness collapse shoulder tip pain SOB