Early pregnancy problems and miscarriage Flashcards
4 weeks
Rapid growth
Suscept to toxin exposure, infection and rays
Notocord and gastrulation
Somites, primitive heart tube and vasculature
6 weeks
Heart beat and bulging NT closes Otic pits Limb, ureteric and lung bugs Spleen
7 weeks
Optic vesicles and cups and brain vesicles
Rudimentary blood through vessels connects to yolk and chorionic mem
Metanephros and stomach diff
8 weeks
Fetus - major struc growth and dev
Toxin exp - physical abnorm/congen malform
RBC prod in liver, eye movment
18 weeks
Lanugo over entire body, eyebrows, eyelashes, nails
Increased muscle dev and activity
Miscarriage
Spont loss of pregnancy before foetus reaches viability (conception - 24wk) Biochem - really early 1T - before 12wk Mid T - 12-24 wk Still birth - after 24 wk
Risk factors
Gest age, chr abnorm, mat/pat age, previous MC, pre-preg weight, alcohol, smoking, caffience
Types of MC
Threatened - bleeding, sac sep from uterus
Invetiable - cervical os opens
In/complete
Septic - likely due to infection
Anembryonic - blighted ovum
Missed (silent/delayed) - fetus dead but not expelled
US criteria
CRL greater than 7mm and no HB
Gest sac greater than 25mm and no embryo
Ab of emb with HB 2 wk after US that showed gest sac with no yolk sac
Ab of emb with HB 11 days after US that showed gest sac with yolk sac
Pregnancy of undetermined location
See pregnancy hormone level increase but no fetus
If BhCG doesnt double in 8hr - not preg
Ectopic preg
Pregnancy outside the uterine cavity
Symptoms - abdom/pelvic pain, missed period, vaginal bleeding, dizziness, fainting
Signs - pelvic, adnexal, abdom tenderness, abdom distension
Recurrent MC
Loss of 3+ consec preg
Risk factors
- enviro: mat age, previous MC, smoking, alcohol
- aPL ab: inhib TB funch
- genetic: chr abnorm
- anatom: uterine malform, cervical weakness
- endocrine: uncont diab, PCOS, thyroid dysfunc
- immune: uNK cells
- infection and thrombophilia
Refer to specialist clinic for testing
Gestational trophoblastic disease
TB cells grow inside uterus
Hydatidiform mole
Complete mole - 2 pat, no mat genes, no fetus
Partial - 2 pat, 1 mat, fetus (non-viable). GR of fetus and disturbed organogenesis
GTD risk factors
age, ethnic, low pt, folic acid and carotene diets, egg defects, abnorm uterus, blood group A
