EARLY Pregnancy Problems

Question 1

Any things prior to 12 weeks is?

Answer 1

Gynecology

Question 2

What to ask woman who presents to ED with some bleeding from vagina

Answer 2

Possible you’re preg?
Any N/&V and go away?
Amenorrhoea

Question 3

Important about bHCG?

Answer 3

The quantitative amount: should double every 48 hours until week 8.

Question 4

U/s and early preg?

Answer 4

U/S and bHCG is most useful

• If bHCG hits 1500-3500, will see a gestational sac and yolk sac
• bHCG 20 000 should see 5-10mm embryo at 7 weeks.

Question 5

When can you see something u/S in early preg?

Answer 5

BHCG needs to be at least 1500 or you may not see anything especially if

Question 6

Hyperemesis Gravidarum, likely in who?

Answer 6

Multiple pregs

Question 7

Hyperemesis Gravidarum is?

Answer 7

Weight loss exceeding 5%, dehydration, keto urea

-onset 4-10 weeks

Question 8

Test for Hyperemesis Gravidarum?

Answer 8

U/S to exclude multiple

Question 9

Management of Hyperemesis Gravidarum?

Answer 9

Remove mole if it’s mole

Ginger/acupressure
Diet
Avoid triggers
Psych

Question 10

Hyperemesis Gravidarum, pharma?

Answer 10

B6
Maxalon
Phenergan: sedating
Ondansetron (constipation G)
Admission

Question 11

What is EPAS?

Answer 11

Early pregnancy asessment service

Question 12

Threatened miscarriage is?

Answer 12

Have some bleeding but a viable fetal heart then only 1-2% miscarriage

Question 13

Complete miscarraige?

Answer 13

All products gone

Question 14

Incomplete miscarriage?

Answer 14

Some products of conception remains

Question 15

Septic miscarraige

Answer 15

Dangerous, rare,
Can die.
Used to be When termination was illegal.

Question 16

Causes of miscarriage?

Answer 16

85% chromosomal abnormalities

Question 17

Maternal causes of miscarriage

Answer 17

Advanced age
Diabetes
Thyroid
Phospholipid, lupus
Lifestyle

TRAUMA (domestic violence)

Question 18

What causes miscarraige at 12-20 weeks (midterm)

Answer 18

Uterine septum
big Fibroid
Cervical incompetence

Question 19

Bleeding in preg women?

Answer 19

Most are fit ned will compensate until the end.

Question 20

Why do you get bradycardia and hypotension in miscarriage?

Answer 20

Cervical os is innervated by vagus

Question 21

Dx of miscarriage?

Answer 21

CRL >7mm with no heart beat

Empty Gestational sac without yolk sac or fetal pole

Question 22

What is a blighted ovum? When find out?

Answer 22

Empty gestational sac

See at 12 weeks.

Question 23

Mx of miscarraige?

Answer 23

Expectant: wait and see (70%)
Medical - misoprostol (80%)
Surgical (D&C)uterine perforation
-ABx needed to prevent ascending infection
-No difference in satisfaction if mother chooses

Question 24

D&C for miscarriage is actually?

Answer 24

dilation and Suction curettage

Question 25

When is recurrent miscarriage?

Answer 25

3 consecutive miscarriages before investigations

Question 26

Pregnancy of unknown location is?

Answer 26

Dont’ know where it is.

Positive preg test, can’t see on U/S with bHCG doubling

Question 27

When need scan For PUL?

Answer 27

If stable: after 3 BHCG Abnormal= scan

If they’re not well, then act now

Question 28

Commonest reason for ectopic preg is?

Answer 28

Being preg!

93% ampullae

Question 29

Which ectopic pregnancy is worse for bleeding?

Answer 29

Isthmus 4%

Question 30

Ovary blood supply?

Answer 30

Ovarian artery directly from Aorta

Question 31

clinical Presentation of ectopic pregnancy?

Answer 31

Acute: low Abdo pain (90%) peritoneal irritation

Vaginal bleeding (50%) shedding decidua

-adenexa L tenderness
Acute abdomen
Shoulder tip pain
Fainting

Question 32

Recurrence of ectopic pregnancy?

Answer 32

10-15%

Question 33

Methotrexate for ectopic pregnancy?

Answer 33

bHCG