Miscarriage + Termination of Pregnancy Flashcards
what is a molar pregnancy?
pre malignant tumour of trophoblastic villi (placenta)
why does a molar pregnancy happen?
implanted non viable fertilised egg
what is a complete mole?
egg with no DNA
what is a partial mole?
haploid egg, fetus may be present
what is a risk of a complete mole?
choriocarcinoma
features of a molar pregnancy?
bleeding grapelike tissue SOB (PE) fundus > dates extreme morning sickness
what are the two Ix for molar pregnancy and their results?
pregnancy test - strongly +ve
US - snowstorm appearance
Tx for molar pregnancy?
surgery
MTX
anti D
how long should pregnancy be avoided for after a molar pregnancy?
1 year
what is an ectopic pregnancy?
when fertilised ovum implants outside the uterine cavity
most common location of ectopic?
ampulla
features of ectopic pregnancy?
abdo pain bleeding dizzy diarrhoea vomiting shoulder tip pain
Ix for ectopic?
beta HCG
FBC
US
Tx for a ectopic with shock/bleeding?
laparotomy
what is medical Tx for ectopic? what is criteria?
MTX no pain unruptured decreased HCG no IU pregnancy
what is 2 other types of management for ectopic?
surgery
conservative
what is a miscarriage?
loss of pregnancy <24wks gestation
what is a threatened miscarriage? is os open/closed?
bleeding and cramping but pregnancy continues
os closed
what is an incomplete miscarriage? os open/closed?
part of pregnancy is lot
os open
what is an early fetal demise?
pregnancy in situ but no heartbeat
features of a miscarriage?
bleeding
cramping
suprapubic/lower back pain
passing fetus/blood/blood clots
what is a complete miscarriage?
all of pregnancy is lost
Ix for a miscarriage?
pregnancy test
FBC
Rhesus blood group
TVUS
management options for a miscarriage?
conservative
medical
surgical
what is the medical Tx of a miscarriage?
mifepristone
24-48 hrs later misoprostol
when is anti D given?
rhesus -ve and threatened miscarriage >12 wks
within 72hours
what is counted as recurrent miscarriage?
3 or more before 24wks gestation
causes of recurrent miscarriage?
thrombophilia
anti phospholipid syndrome
chromosomal abnormality
when can TOP be done until?
24 weeks
when can MVA be done?
6-12 weeks
when can medical TOP be done?
9-24wks
when can D+C be done for TOP?
13-24wks
not in scotland
