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Fetus Module > early pregnancy problems and miscarriage > Flashcards

early pregnancy problems and miscarriage Flashcards

1
Q

when is a pregnancy measured from?

A

a womans last menstrual period

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2
Q

when is a foetus’s survival chance 50%?

A

24 weeks

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3
Q

what is the definition of miscarriage?

A

spontaneous loss of pregnancy before the fetus reaches viability (all pregnancy losses from conception until 24wks of gestation)

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4
Q

what is the risk of miscarriage <6wks?

A

25%
6-12wks = 12-20%
12wks = 1-2%

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5
Q

is a fetus has a chromosomal abnormality what is the risk of miscarriage?

A

50%

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6
Q

what are the risk factors from miscarriage?

A 
maternal and paternal age 
previous miscarriage 
pre-pregnancy weight 
alcohol intake 
smoking 
excessive caffeine
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7
Q

what are the different types of miscarriage?

A 
threatened miscarriage 
inevitable miscarriage 
incomplete miscarriage 
complete miscarriage 
septic miscarriage 
anembryonic miscarriage 
missed miscarriage
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8
Q

what is the ultrasound diagnosis of miscarriage?

A

crown-rump length of at last 7mm and no heart beat
mean gestational sac diameter of at least 25mm and no embryo
absence of embryo with heartbeat at least 2wwks after an US that showed gestational sac without yolk sac
absence of embryo with heartbeat at least 11days after an ultrasound scan that showed a gestational sac with a yolk sac

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9
Q

how big is the gestational sac at 4 wks gestation?

A

3-6mm

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10
Q

when can you see the yolk sac on US?

A

5 wks

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11
Q

what are the stages of miscarriage?

A
  1. US shows early anembryonic pregnancy or fetal death
  2. vaginal bleeding occurs (threatened)
  3. open cervical os (inevitable miscarriage)
  4. miscarriage (products of conception are expelled, cramps and bleeding soon subside)
  5. US may show uterine contents - deicdua, blood, some villi
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12
Q

what can cause a threatening miscarriage?

A

vaginal bleeding
beginning of miscarriage
subchorionic haematoma

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13
Q

what is a missed miscarriage?

A

empty gestational sac

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14
Q

what is an incomplete miscarriage?

A

products of conception within endometrial cavity

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15
Q

what is a complete miscarriage?

A

nothing in endometrial cavity

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16
Q

what are the outcomes when patient presents with early pregnancy problems?

A

pregnancy of undetermined location
miscarriage
ectopic
ongoing pregnancy

17
Q

what is an ectopic pregnancy?

A

a pregnancy located outside the uterine cavity, usually in the Fallopian tube
other sites:infundibular, tubal, abdominal, interstitial, cervical, ovarian

18
Q

what are some common symptoms of ectopic pregnancy?

A

abdominal or pelvic pain
amenorrhoea or missed period
vaginal bleeding +/- clots
other symptoms = dizziness, fainting, syncope, shoulder tip pain, urinary symptoms, passage of tissue, rectal pressure/pain on defecation

19
Q

what are some common signs of ectopic pregnancy?

A

pelvic tenderness
adnexal tenderness
abdominal tenderness
others = cervical motion tenderness, rebound tenderness, pallor, abdominal distension, enlarged uterus, tachycardia, hypotension, shock

20
Q

what is the definition of recurrent miscarriage?

A

loss of three or more consecutive pregnancies

21
Q

what are the risk factors for recurrent miscarriage?

A 
environmental = maternal age, previous miscarriage, advanced paternal age, obesity, alcohol, smoking excessive caffeine
antiphopholipid antibody (inhibits trophoblast function and complement activation)
genetic factors = balanced translocation, chromosomal abnormalities 
anatomical factors = uterine malformations, cervical weakness 
endocrine = uncontrolled diabetes, thyroid dysfunction, PCOS 
immune factors = uterine natural killer cells 
infection 
thrombophlia
22
Q

what investigations are used in recurrent miscarriage?

A 
referral to specialist clinic 
antiphospholipid tests 
cytogenetic analysis 
pelvic US 
thrombilia tests
23
Q

what is gestational trophoblastic disease?

A

hydatidform mole
80% benign
10-15% invasive mole

24
Q

what are the 2 types of molar pregnancy?

A

complete mole = 2 sets of paternal genes, no maternal genes, no fetus
partial mole = 3 sets of genes, 1 maternal 2 paternal, no visible fetus

25
Q

what are the risk factors for molar pregnancy?

A 
extremes of age 
previous molar pregnancy 
diets low in protein, folic acid and carotene 
defects in egg 
abnormalities of uterus 
women with blood group A
26
Q

how is a mole pregnancy diagnosed?

A

vaginal bleeding after amenorrhoea
hyperemesis gravidarum, hyperthyroidism
passing of grape like vesicles
on US complete mole = absent gestational sac and complex echogenic intrauterine mass with cystic spaces
partial mole = may resemble normal conception
ovaries may develop theca lutein cysts
snowstorm seen on US

Fetus Module (18 decks)

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