Early pregnancy problems Witrak

Question 1

What are the two main categories of what can go really wrong in the first trimester?

Answer 1

Spontaneous abortion/miscarriage

Ectopic Pregnancy

Question 2

What are the very vague symptoms associated with spontaneous abortions?

Answer 2

Abdominal pain
Amenorrhea
Vaginal bleeding

Question 3

What are some associations of spontaneous abortions?

Answer 3

PCOS
Chromosome abnormalities
Structural uterine abnormalities
Cervical incompetence
Systemic maternal disease
Thrombophilias (Factor V Leiden, Anti-phospholipid syndrome)
Smoking/EtOH

Question 4

Were is the most common location of an ectopic pregnancy?

Answer 4

In the tubes (90%)

Question 5

What are the risk factors for having an ectopic pregnancy?

Answer 5

Prior tubal injury (PID, endometriosis, pelvic surgery)

IUD placement

Question 6

What symptoms are associated with ectopic pregnancies?

Answer 6

Abdominal pain

If tubal ruptures → hemoperitoneum, shock, death

Question 7

How can an ectopic pregnancy be diagnosed?

Answer 7

Serum hCG and transvaginal ultrasound

Endometrial curettage

Question 8

What is seen with serum hCG levels in women with an ectopic pregnancy?

Answer 8

< 50% hCG increase every 2 days…normal is > 50% increase in same time

Question 9

When is an endometrial curettage performed?

Answer 9

If there is a slow hCG rise

Question 10

What are some treatment options for ectopic pregnancy?

Answer 10

Salpingectomy
Salpingostomy
Methotrexate