Gestational Pathology Flashcards
What is the most common site of ectopic pregnancy? What is a key risk factor?
Most common site is the lumen of the fallopian tube. Key risk factor is scarring (secondary to pelvic inflammatory disease or endometriosis)
A 23 year old postal worker presents to the ED with lower quadrant abdominal pain. She mentions that this started three weeks after a missed period. What is on top of your ddx? How would you treat? What are some majror complications?
Ectopic pregnancy. Surgical emergency. Majror complications are bleeding into the fallopian tube (hematosalpinx) and rupture.
When do miscarriages often happen? How do they present? What 4 things usually causes them?
Occur before 20 weeks gestation (usually during first trimester). Present as vaginal bleeding, cramp-ike pain and passage of fetal tissue. Most often due to chromosomal anomalies (trisomy 16). Other causes include hypercoagulable states (antiphospholipid syndrome), congenital infection and exposure to teratogens (especially during the first 2 weeks of embryogenesis).
What do teratogens increase the risk of on the first two weeks of gestation?
Spontaneous abortion
What do teratogens increase the risk of on weeks 3 - 8?
Risk of organ malformation
What do teratogens increase the risk of on months 3 - 9?
Risk of organ hypoplasia
What do teratogens increase the risk of on months 3 - 9?
Risk of organ hypoplasia
A patient presents with third trimester bleeding. You suspect something is wrong with her placenta. What could be going on? What is the course of action?
Placenta previa where there is implantation of the placenta in the lower uterine segment. Placenta overlies cervical os. Often requires delivery of fetus by caesarian section.
A patient presents with third trimester bleeding and fetal insufficiency. You suspect something is wrong with her placenta. What could be going on? What is this disorder known for?
Placental abruption which is separation of the placenta from the decidua prior to delivery of the fetus. Common cause of still-birth.
A patient presents with postpartum bleeding and difficult delivery of the placenta . You suspect something is wrong with her placenta. What could be going on? What is the course of action?
Placenta accreta which is improper implantation of placenta into the myometrium with little or no intervening decidua. Often requires hysterectomy.
A woman in her third trimester presents with hypertension, proteinuria and edema. She complains of headaches and visual abnormalities. What could be causing this presentation? How is it treated?
Preeclampsia which is a pregnancy induced hypertension, proteinuria and edema. Due to abnormality of the maternal-fetal vascular interface in the placenta and resolves with delivery.
A woman in her third trimester presents with hypertension, proteinuria and edema. She complains of headaches and visual abnormalities. What could be causing this presentation? How is it treated?
Preeclampsia which is a pregnancy induced hypertension, proteinuria and edema. Due to abnormality of the maternal-fetal vascular interface in the placenta and resolves with delivery.
A woman in her third trimester presents with hypertension, proteinuria and edema and seizures. She complains of headaches and visual abnormalities. What could be causing this presentation? How is it treated?
Eclampsia. Immediate delivery
A woman in her third trimester presents with hypertension, proteinuria and edema. She complains of headaches and visual abnormalities. Her lab values are notable for hemolysis, elevated liver enzymes and low platelets. What could be causing this presentation? How is it treated?
This is HEELP and warrants immediate delivery.
What is the age group for Sudden Infant Death Syndrome? When do infants usually expire? What are the risk factors?
1 month to 1 year old without obvious cause. Infants usually expire during sleep. Risk factors include sleeping on stomach, exposure to cigarette smoke, and prematurity.
