Early Pregnancy Loss, Ectopic Pregnancy, and Rh Isoimmunization (Moulton) Flashcards
first trimester timing
first day of last menstrual period to 13 weeks + 6 days
second trimester timing
14 weeks to 27 weeks + 6 days
Third trimester timing
28 weeks to 42 weeks
What is estimated date of confinement
the due date (40 weeks after the first day of the last menstrual period)
abortion timing definition
< 20 weeks
preterm delivery timing definition
20 to 36 weeks + 6 days
full term delivery timing definition
37-42 weeks
postdates definition
> 42 weeks
first test on a woman presenting with vaginal bleeding
pregnancy test
when is hcg first detected in serum
6-8 days after ovulation
is a titer <5 mIU/L positive?
no
What level of HCG can a urine pregnancy test detect?
25 m IU/L
How does the level of hCG increase?
hCG levels should double every 2 days (peaks at 10 weeks at 100,000 IU/L)
At what level of hCG can gestational sac be seen?
at 1500-2000 mIU/L with transvaginal U.S.
What is the discriminatory level of hCG?
1500-2000 mIU/L –> will see gestational sac
At what level of hCG and at what time is a fetal pole seen?
5200 mIU/L or around 5 weeks
Lab findings suggestive of abnormal IUP or ectopic pregnancy
abnormal rise in hCG (< 53% in 48 hours)
biochemical pregnancy
the presence of hCG 7-10 days after ovulation but in whom menstruation occurs when expected
abortus
fetus lost before 20 weeks gestation, less than 500 grams
most common cause of first trimester SAB’s
chromosome abnormalities
most common chromosomal abnormality
45 XO (Turner’s syndrome)
most common class of chromosomal abnormalities
trisomy class
most common trisomy leading to abortion
trisomy 16
threatened abortion
- vaginal bleeding and closed cervix
- 25-50% result in loss of pregnancy
- treatment is expected management
