Ectopic Flashcards
When does rupture of tubal pregnancy in the isthmus usually occur?
6-8 weeks
MCC of pregnancy-related death during the first trimester
Ectopic pregnancy
When does rupture of interstitial ectopic pregnancy usually occur?
16 weeks
When does ampullary ectopic pregnancy rupture usually occur?
8-12 weeks
Most identified risk factor for ectopic pregnancy
Previous PID
Triad of ectopic pregnancy
Abdominal pain
Amenorrhea
Vaginal bleeding
Expected HCG levels for ectopic pregnancy
> 1,500
Expected serum progesterone levels in ectopic pregnancy
< 5 ng/ml –> intrauterine with dead fetus or ectopic
Gold standard for diagnosis of ectopic pregnancy
Laparoscopy
Indications for medical management of ectopic pregnancy
Pregnancy < 6 weeks AOG Mass < 3.5 cm Absence of FHT HCG: < 15,000 No evidence of repture
Bleeding a consequence of velamentous insertion of umbilical cord
Vasa previa
Types of abruptio placenta
Concealed
Marginal
Overt
Bleeding into the decidua basalis with separation of blood between the mother and baby
Abruptio placenta
Findings in ultrasound in abruptio placenta
Retroplacental blood clots
Anesthesia of choice for vaginal delivery of abruptio placenta
Pudendal block
Anesthesia of choice for CS of abruptio placenta
GA
Couvelaire uterus
Aka uterine apoplexy
Full thickness laceration of uterine myometrium
Uterine rupture
Management of uterine rupture
Immediate emergency CS
PROM
> 37 weeks AOG
ROM 1 hour prior to onset or labor
Prolonged PROM
> 18 hours prior to onset of labor
PPROM
<37 weeks AOG
ROM at least 1 hour prior to onset of labor
Management of PPRPOM patient
If < 34 weeks: give steroids for baby’s lung maturity
If > 34 weeks: deliver
