Gynäkologie und Geburtshilfe

Question 1

Definitionskriterien für hypertensive Schwangerschaftserkrankungen

Answer 1

Gestationshypertonie

• Manifestation > 20 SSW
• Hypertonus > 140/90 mmHg in 2 Messungen in Abstand > 4 h

Präeklampsie

• Proteinurie oder Endorgan-Dysfunktion
• Schwere Form der Präeklampsie: HELLP-Syndrom
• überlagerte Präeklampsie

Eklampsie
- schwere From der Präeklampsie mit Krampfanfällen und Koma

Postpartale Hypertonie
- < 12 Wochen Dauer

Question 2

Ätiologie hypertensiver Schwangerschaftserkrankungen

Answer 2

General risk factors

• Thrombophilia (e.g., antiphospholipid syndrome)
• < 20 or > 35 years of age
• African-American descent
• Diabetes mellitus or gestational diabetes
• Chronic hypertension
• Chronic renal disease (e.g., SLE)
• Obesity (BMI ≥ 30)

Pregnancy-related risk factors

• Nulliparity
• Multiple gestation
• Hydatidiform mole
• Previous preeclampsia
• Chromosomal anomalies or congenital structural anomalies
• Family history

Question 3

HCG

Answer 3

Produced by syncytiotrophoblast
10 d after fertilisation
Peaking at 9-10 weeks
Gradually falling to plateau at 20-22 weeks
Maintaining Corpus luteum production, steroid production in adrenal gland and Testosteron in male testes
High levels: twin pregnancy, hydatiform mole, choriocarcinoma, embryonal carcinoma
Low levels: ectopic pregnancy, threatened abortion, missed abortion

Question 4

Heavy menstrual bleeding

Answer 4

PALM-COEIN

• Polyps
• Adenomyosis
• Leiomyomas
• Malignancy and hyperplasia
• Coagulopathy
• Ovulatory dysfunction
• Endometrial
• Iatrogenic
• Not otherwise classified.