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OBGYN > OB first trimester abnormalities registry review > Flashcards

OB first trimester abnormalities registry review Flashcards

1
Q

Ectopic pregnancy

A

A pregnancy located anywhere other than the central uterine cavity

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2
Q

Most common cause of pelvic pain with positive pregnancy test

A

Ectopic pregnancy

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3
Q

Most common location of ectopic pregnancy

A

Ampulla of fallopian tube

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4
Q

Most dangerous location of ectopic pregnancy

A

Interstitial/corneal because of rupture and hemorrhage

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5
Q

Heterotopic pregnancy

A

IUP and coexisting ectopic. Rare. Most often associated with assisted reproduction. Risk: hx PID, endometriosis, previous ectopic

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6
Q

hCG level 1,000-2,000 with no IUP

A

Suspect ectopic

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7
Q

Clinical presentation of ectopic pregnancy

A

-Pain, bleeding, palpable mass
-Lower than expected hCG, low hematocrit, shoulder pain

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8
Q

Sonographic appearance of ectopic pregnancy

A

-Extrauterine GS “live” pregnancy
-Complex adnexal mass or adnexal ring sign
-Free or complex fluid in pelvis
-Pseudogestational sac
-Poor decidual reaction in endo

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9
Q

Gestational trophoblastic disease (molar pregnancy)

A

Abnormal combination of male and female gametes resulting in rapid proliferation of trophoblastic cells

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10
Q

Trophoblastic hCG production in molar pregnancy

A

Excessive levels of hCG or rapidly rising levels; placenta grows out of control, takes over, undergoes degeneration becoming complex with cystic changes

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11
Q

Complete hydatidiform mole

A

Absence of fetus or gestational sac. Benign with malignant potential, clear defined boarders contained within myometrium

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12
Q

Partial hydatidiform mole

A

Coexisting IUP/GS and possibly fetus. Minimal malignant potential

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13
Q

Most common gestational trophoblastic disease

A

Complete hydatidiform mole

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14
Q

Invasive molar (chorioadenoma destruens)

A

Molar pregnancy that becomes malignant and invades into myometrium through uterine wall and into peritoneum

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15
Q

Choriocarcinoma

A

Most malignant progressive form with possible mets to lung (most common), liver, brain

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16
Q

Clinical presentation of molar pregnancy

A

Hyperemesis, markedly elevated hCG, bleeding, enlarged uterus, hypertension

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17
Q

Sonographic appearance of molar pregnancy

A

Large complex mass within uterus, multiple cystic areas throughout, loss of myometrium or boarders if invasive, bilateral theca lutein cyst

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18
Q

Non progressive pregnancies/miscarriages

A

Either hCG or sonographic appearances do not match what is expected. LMP not reliable, base of hCG + sono or sono alone

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19
Q

Low hCG or S<D

A

-Incorrect dating
-Ectopic
-Non progressive/failed pregnancy

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20
Q

High hCG or S>D

A

-Incorrect dating
-Multiple gestations
-Gestational trophoblastic disease (molar pregnancy)

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21
Q

Sonographic indication of abnormal pregnancy development

A

-GS greater than 10mm MSD without visible yolk sac
-GS greater than 25mm MSD without fetal pole
-Enlarged YS greater than or equal to 6mm
-Collapsed GS/ poor decidual reaction

22
Q

Blighted ovum (Anembryonic pregnancy)

A

Large gestational sac without yolk sac or embryo, usually shows poor decidual reaction

23
Q

Sonographic appearance of blighted ovum

A

GS > 10mm + no YS
GS > 25mm + no FYP

24
Q

Clinical presentation of blighted ovum

A

Vaginal bleeding, low b-hCG

25
Q

Embryonic/fetal demise

A

Death of embryo or fetus

26
Q

Confirmation of embryonic/fetal demise

A

Fetal pole greater than or equal to 5mm with no cardiac activity

27
Q

Early sonographic indication of early/impending demise

A

Irregular shaped GS, enlarged YS

28
Q

Clinical appearance of embryonic/fetal demise

A

Bleeding, small for dates, low hCG

29
Q

Abortion

A

Termination of pregnancy before viability whether elective or not

30
Q

Spontaneous abortion

A

Naturally occurring miscarriage

31
Q

Clinical/sono findings for threatened miscarriage

A

Spotting, low FHR

32
Q

Clinical/sono findings for missed miscarriage

A

Spotting/low hCG, intact demise

33
Q

Clinical/sono finding for incomplete miscarriage

A

Heavy bleeding/+hCG, RPOC

34
Q

RPOC

A

Retained products of conception

35
Q

Clinical/sono findings for complete miscarriage

A

Bleeding/ - hCG, normal endometrium

36
Q

Clinical/sono findings for inevitable miscarriages

A

Cramping/spotting, low lying GS

37
Q

Incomplete miscarriage

A

Miscarriage is still in process and there are retained products of conception with internal flow within the cavity

38
Q

Complete miscarriage

A

Finished miscarriage, cavity is empty and endometrium is thin, similar to early proliferative endo

39
Q

Subchorionic hemorrhage (SCH)

A

Bleed between endometrium and gestational sac

40
Q

NON poor prognosis of SCH

A

If hemorrhage is 50% or greater than GS and close to internal os

41
Q

Clinical presentation of SCH

A

Vaginal bleeding or spotting, possible cramping

42
Q

Sonographic appearance of SCH

A

Crescent-shaped, hypoechoic or medium level echoed area adjacent to GS

43
Q

Myomas (fibroids) during pregnancy

A

Location and size are important to document because they can complicate delivery

44
Q

Fibroid growth during pregnancy

A

Stimulated by estrogen, grow during pregnancy due to increased estrogen… *Don’t confuse with contractions

45
Q

Sonographic appearance of contractions

A

Round, masslike within the myometrium but will disappear within 30 mins

46
Q

Corpus Luteum of pregnancy

A

Physiological, functional cyst that maintains endo by secreting progesterone, usually 2-3cm but may grow up to 10cm

47
Q

Most common pelvic mass of 1st trimester

A

Corpus luteum

48
Q

What maintains corpus luteum

A

hCG

49
Q

Clinical presentation of corpus luteum

A

Asymptomatic or pain due to size or hemorrhage

50
Q

Sonographic appearance of corpus luteum

A

Simple or complex/hemorrhagic cyst

OBGYN (17 decks)

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