Early pregnancy problems

Question 1

Miscarriage

Answer 1

pregnancy failure before the completion of 24 weeks gestation

Question 2

Early miscarriage

Answer 2

less than 12 weeks pregnancy

Question 3

Late miscarriage

Answer 3

from 12 -24 weeks pregnancy

Question 4

Recurrent miscarriage

Answer 4

3 or more consecutive losses before 24 weeks

• if one partner has a chromosomal abnormality

Question 5

Causes of miscarriage

Answer 5

1. maternal age
2. Chromosomal abnormality
3. Congenital defect of uterus - there is a septum
4. Fibroids - intefere with implanatation
5. Antiphospholipid syndrome - autoimmune, predisposes to blood clots/Thrombophilia - thrombosis of uteroplacental circulation causes blood clot
6. Cervical weakness - dilates too early causing loss of foetus

Question 6

Pathophys of ectopic pregnancy

Answer 6

• Implantation anywhere outside the uterine cavity mainly in the fallopian tube
• Fallopian tube should transports egg from ovary to uterus

Question 7

symptoms of ectopic pregnancy

Answer 7

• Abnormal vaginal bleeding
• Abdominal pain - rebound tenderness
• Tachycardia - caused by bloodloss

Question 8

Invest of ectopic pregnancy

Answer 8

• urine HCG
• ultrasound
• laproscopy

Question 9

Risk factors of ectopic pregnancy

Answer 9

• Damage to fallopian tube - Pelvic inflammatory disease(caused by sti), surgery to fallopian tubes
• Endometriosis
• Smoking
• Previous ectopic pregnancy
• Fertility treatment - Invitro

Question 10

Postpartum haemorrhage

Answer 10

1. Primary - more than 500 ml loss within 24 hours of delivery
2. Secondary - significant loss between 24 hours to 6 weeks

Question 11

Causes of primary postpartum haemorrhage - TONE

Answer 11

1. Tone - atony
   - Myometrium is the smooth muscle of uterus and will contract after delivery to clamp placental arteries to stop blood loss.
   • Repeated distention of uterus from multiplepregnancies
   •Muscle fatigue from long labour
   MYOMETRIUM IS UNABLE TO CONTRACT AS STRONGLY AND IS UNABLE TO CLAMP THE PLACENTAL ARTERIES

Question 12

Causes of primary postpartum haemorrhage - TRAUMA

Answer 12

• Vaginal tear

- incision from caesuras

Question 13

Causes of primary postpartum haemorrhage - TISSUE

Answer 13

1. Placenta retention in the urterine cavity
2. prevents effective uterine contraction
3. Uterine atony

Question 14

Causes of primary postpartum haemorrhage - THROMBIN

Answer 14

1. Deficiency of coagulation factors makes bleeding more likely / Von Willebrands etc

Question 15

Causes of secondary postpartum haemorrhage

Answer 15

1. Endometritis - inflammation of lining of uterus

2. Persistent trophoblastic disease- molar pregnancies