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Reproduction > Lecture 14 Complications in Pregnancy > Flashcards

Lecture 14 Complications in Pregnancy Flashcards

1
Q

The cervix in a threatened miscarriage is (closed/open)

A

Closed

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2
Q

The cervix in an inevitable miscarriage is (closed/open)

A

Open

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3
Q

What may be seen during a scan when a missed miscarriage is suspected

A

Empty gestational sac

Foetal pole with no foetal heart

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4
Q

What is an incomplete miscarriage

A

Most of pregnancy is expelled out
Some products of pregnancy remaining in the uterus
Open cervix
Heavy bleeding

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5
Q

What is a complete miscarriage

A

Passed all products of conception

Cervix closed

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6
Q

What abnormal conceptus causes of spontaneous miscarriage

A

Chromosomal
Genetic
Structural

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7
Q

What uterine abnormalities causes spontaneous miscarriages

A

Congenital

Fibroids

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8
Q

What maternal factors can cause a spontaneous miscarriage

A 
Increasing age
Diabetes
Hormonal imbalance
SLE
Thyroid disease
Infection
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9
Q

How is a threatened miscarriage managed

A

Conservative- just wait

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10
Q

How are inevitable miscarriages managed

A

If bleeding heavy may need evacuation

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11
Q

How are missed miscarriages managed

A

Conservative
Medical- Prostaglandins (misoprostol)
Surgical

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12
Q

How is a septic miscarriage managed

A

Antibiotics and evacuate uterus

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13
Q

What is an ectopic pregnancy

A

Pregnancy implants outside the uterine cavity

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14
Q

What’s the most common site in the Fallopian tube for an ectopic pregnancy

A

Ampullary

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15
Q

What are the risk factors for ectopic pregnancy

A

Pelvic inflammatory disease
Previous tubal surgery
Previous ectopic
Assisted conception

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16
Q

What is the clinical presentation of ectopic pregnancy

A

Period of ammenorhoea
Vaginal bleeding
Pain abdomen
GI or urinary symptoms

17
Q

What are the investigations for an ectopic pregnancy

A

Scan

Serum BHCG

18
Q

How is ectopic pregnancy managed

A

Methotrexate

Salpingectomy, Salpinotomy

19
Q

What is Grade I Placenta Praaevia

A

Encroaching on the lower segment but not the internal cerivcal os

20
Q

What is Grade II Placenta Praaevia

A

Placenta reaches the internal os

21
Q

What is Grade III Placenta Praaevia

A

Eccentrically covers the os

22
Q

What is Grade IV Placenta Praaevia

A

Central placenta praaevia

23
Q

What are the clinical features of placenta praaevia

A

Soft, non-tender uterus

Foetal malpresentation

24
Q

How is placental praaevia diagnosed

A

US scan to located placental site

NO VAGINAL EXAMINATION

25
Q

How is Placental Praaevia managed?

A

C-section (watch for PPH)
Medical (oxytocin, ergometrine, crab-Prost, transgenic acid)
Balloon tamponade
Surgical (B lymph suture, ligation of uterine, iliac vessels, hysterectomy)

26
Q

What factors are associated the placental abruption

A 
Pre-eclampsia
Chronic hypertension
Polyhydramnios
Smoking, increasing age, parity
Previous abruption
Cocaine use
27
Q

What are the 3 clinical types of placental abruption

A

Revealed (see blood)
Concealed (bleeding but not visible)
Concealed

28
Q

What is the clinical presentation of placental abruption

A

Pain
Vaginal bleeding (may be minimal)
Increased uterine activity

29
Q

How are preterm deliveries managed

A

Test foetal fibronectin

30
Q

Define mild hypertension

A

Diastolic BP 90-99

Systolic BP 140-49

31
Q

Define moderate hypertension

A

Diastolic BP 100-109

Systolic BP 150-159

32
Q

Define severe hypertension

A

Diastolic >110

Systolic BP>160

33
Q

Define pre-eclampsia

A

Mild HT on two occasions more than 4 hours apart

34
Q

Describe the clinical presentation of pre-eclampsia

A 
Seizures
Cerebral haemorrhage
Stroke
Haemolysis
Elevated liver enzymes
Low platelets
DIC
Renal failure
Pulmonary oedema
Cardiac failure
35
Q

Name the symptoms and sign of severe PET

A 
Headache
Blurry vision
Epigastric pain
Pain below ribs
Vomiting
Swelling of hands and face
Urine proteinuria
Clonus
Reduce urine output
Convulsions
36
Q

The only cure for PET is_____

A

delivery of the baby and placenta

37
Q

How are seizures/impending seizures treated

A

Magnesium sulphate bolus + IV infusion

IV labetolo, hydralazine

Reproduction (29 decks)

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