Exam 3 - Complications of Pregnancy Flashcards
rare mass, or growth, that forms inside the womb (uterus) at the beginning of pregnancy
Hydatidiform Mole
2 types of Hydatidiform Moles
Complete/Classic - no identifiable fetal tissue
Partial - some recognizable fetal tissue
Risk Factors: Hydatidiform Mole
Teenagers
Women over 35
Previous miscarriage
Signs & Symptoms: Hydatidiform Mole
Vaginal Bleeding (97%)
Hyperemesis
Preeclampsia (27%) - atypical due to first tri
Hyperthyroidism
Signs & Symptoms: Incomplete Hydatidiform Mole
Vaginal bleeding
Absence of fetal heart tones
Dx: Hydatidiform mole
Ultrasound
“snowstorm” pattern
HCG levels will be elevated
Tx: Hydatidiform mole
Evacuation and curettage
OR
Hysterectomy
What percentage of Hydatidiform moles develop as a malignancy
20%
what should be tested monthly and for how long when performing Hydatidiform mole follow up?
bHCG levels for 6-12 months
how long should contraception be used during the entire follow-up period for Hydatidiform moles?
at least 1 year
any pregnancy that occurs outside of the uterine cavity
Ectopic pregnancy
what is the MC location of Ectopic Pregnancies?
Tubal (97%)
top 3 risk factors of Ectopic Pregnancy
previous tubal surgery
previous ectopic pregnancy
in utero DES exposure (used until 1971)
Clinical Presentation: Ectopic Pregnancy
women of reproductive age abdominal pain vaginal bleeding (~7 weeks after amenorrhea)
Exam Findings: Ectopic Pregnancy
normal/slightly enlarged uterus
vaginal bleeding
pelvic pain with manipulation of cervix
palpable adnexal mass
suspect ectopic pregnancy rupture if…
significant abdominal tenderness
especially if accompanied by:
hypotension, abdominal guarding, rebound tenderness
test of choice for Ectopic pregnancy dx
Ultrasound
which folic acid antagonist is used as a medical tx for ectopic pregnancy?
Methotrexate
approximately what % of women have difficulty conceiving after an ectopic pregnancy?
30%
spontaneous abortion (SA) is classified as pregnancy loss at
a pregnancy complicated by BLEEDING before 20 weeks gestation
“Threatened abortion”
the CERVIX HAS DILATED, but the products of conception have not been expelled
“Inevitable abortion”
ALL PRODUCTS of conception have been passed w/o need for surgical or medical intervention
“Complete abortion”
some, BUT NOT ALL, of the products of conception have been passed; retained products may be part of the fetus, placenta, or membranes
“Incomplete abortion”
a pregnancy in which there is a fetal demise (usually for a number of weeks) but NO UTERINE ACTIVITY to expel the products of conception
“Missed abortion”
a spontaneous abortion that is complicated by intrauterine INFECTION
“Septic abortion”
Three (3) of more consecutive pregnancy losses
“Recurrent spontaneous abortion”
what percentage of pregnancies complicated with bleeding before 20 weeks gestation end in spontaneous abortion?
50%
SA occurs in what % of recognized pregnancies?
20%
what type of abnormality accounts for 49% of SAs
chromosomal abnormality
SA dx
ultrasound
dilated cervix (“inevitable abortion”)
HCG levels
Progesterone levels
progesterone levels lower than ___ng per mL means there will be an abortion
