Loss of baby Flashcards
what is an incomplete miscarriage?
symptoms of bleeding, os open, some tissue remaining
complete miscarriage
no tissue remaining
Molar pregnancy
foetus doesnt form properly in the womb and abnormal cells develop instead of a normal foetus - known as hydatidiform mole
complete mole, where there’s a mass of abnormal cells in the womb and no foetus develops
partial mole,where an abnormalfoetusstarts to form, butit can’t surviveordevelop into a baby
What factors affect risk of miscarriage?
age obesity parental xomal translocation poorly controlled diabetes alcohol, smoking, recreational drug use uterine anomaly
How does a woman who is miscarrying present ?
Bleeding pain can be found at routine scan acute collapse loss of pregnancy symptoms sepsis - pyrexia, tachy
What are some causes of recurrent miscarriages?
xomal abnormalities
anti-phospholipid syndrome
uterine abnormalities
what investigations would be done?
3 or more - karyotyping on tissue of the products of conception
blood tests - thrombophilia screen, anti cardiolipin antibodies, lupus anticoagulant
for uterine abnormalities USS or hysteroscopy
What treatments for recurrent miscarriage?
Aspirin
Tinzaparin
What are risk factors for ectopic pregnancy?
previous ectopic pregnancy tubal damage (previous tubal surgery, history of pelvic infection, history of endometriosis) History of subfertility/IVF Use of progesterone only contraception cystic fibrosis
Describe the clinical presentation of ectopic pregnancy?
classical presentation - pain, bleeding 6-8 weeks gestation, positive pregnancy test, empty uterus on USS
Emergancy - collapsed at A&E, hypotension, tachy, acute abdomen
Management for ectopic pregnancy
hCG monitoring in suspected ectopic, pregnancy of unknown location
detectable 10-11 days post fertilisation. if a pregnancy is of unknown location, a sub-optimal rise in hCG (not double in 48 hours) should provoke strong suspicion of ectopic.
How would you diagnose an ectopic pregnancy?
USS
Laparoscopy
After pt collapse
Treatment for ectopic
conservative
medical - methotrexate injections
surgical - salpingectomy, salpingotomy
In second trimester miscarriage death can be due to in-utero death or premature labour.
what is in-utero death caused by?
fetal abnormality (structural / xomal) Infection placental dysfunction growth restriction anti-phospholipid syndrome
Pre term labour is caused by….
cervical weakness/incompetence uterine abnormality infection rupture of membranes bleeding - from placenta causing uterine irritability
