Obs early pregnancy Flashcards
What’s the most common site for an ectopic pregnancy? Where is an ectopic most likely to rupture?
- Ampulla
- Isthmus
What sign on TVUSS indicates ectopic pregnancy?
Bagel sign
What findings indicate ectopic until proven otherwise?
bhCG >1500 AND no IU pregnancy on USS
Patient X has a positive pregnancy test but nothing in seen on abdo USS/TVUSS. She is stable and her bHCG is 1000. How would you confirm the dx? What factors in the question indicated this?
- Repeat serum bhCG in 48 hrs
- If bHCG doesn’t fall by >50% but doesn’t rise by >63% ectopic is likely
- bHCG <1500 AND patient is stable
What would indicate surgical management of ectopic pregnancy over medical management?
- PAIN
- Size >35mm
- bhCG >5000
- Presence of fetal HR
When is anti-D indicated in women undergoing TOP?
If rhesus -ve and after 10 weeks
Define miscarriage
Spontaneous loss of an intrauterine pregnancy before 24 wks gestation
When is miscarriage classified as early miscarriage ?
<13 wks
When is miscarriage inevitable?
When the cervical os is open enough to admit a finger
What hCG increase would suggest a pregnancy is viable?
If it doubles in 48 hrs
List the classifications of miscarriage
Threatened
Inevitable
Complete
Incomplete
Missed
Recurrent
What finding on TV USS would indicate miscarriage?
An empty gestational sac or metal pole with no heartbeat
Medical management of miscarriage if >12 wks
Mifepristone followed by Misoprostol
Medical management of miscarriage if <12 wks
Misoprostol
How can miscarriage be managed surgically?
LA manual vacuum aspiration
GA electric vacuum aspiration
