Obstetric conditions/complications Flashcards
what are the risk factors for a molar pregnancy?
extremities of gestational age (<20 or >35yrs)
previous molar pregnancy
what is the presentation of a molar pregnancy?
vaginal bleeding (most common) abnormal uterus size for gestation age (small or large)
what investigations are carried out in order to diagnose molar pregnancy?
serum b-HCG
pelvic USS
what features on an USS suggest molar pregnancy?
snow storm appearance and no foetal parts or
small placenta with partial foetal development
what complication can occur from a molar pregnancy?
choriocarcinoma
what is the chance of getting choriocarcinoma from a molar pregnancy and what is the treatment success rate?
20%
success rate is 95%
what is the most common site of an ectopic pregnancy?
ampulla
what are the risk factors for an ectopic pregnancy?
previous ectopic pregnancy FH of ectopic pregnancy reversal of previous sterilisation pelvic inflammatory disease (chlamydia, gonorrhoea) smoking assisted contraception
what is the presentation of an ectopic pregnancy?
vaginal bleeding
pain
GI/urinary symptoms
may present with shock if it ruptures (tachycardia, hypotension, high RR)
what are the treatment options for an ectopic pregnancy?
methotrexate
hysterectomy
salpingectomy
salpingotomy
what is the first line treatment for an ectopic pregnancy?
methotrexate
what investigations would you carry out to diagnose an ectopic pregnancy?
USS - no foetus in uterus, distended area outwit uterus i.e. tube, fluid in the pouch of douglas
serum progesterone and b-HCG (decreased)
what is the aetiology of a spontaneous miscarriage?
congenital abnormality
uterine abnormality i.e. double uterus, uterine septum, fibroids
cervical incompetence (primary vs secondary)
maternal - age, infection, trauma
unknown
what is the management of a spontaneous miscarriage?
medical: prostaglandins (misoprostol)
surgical: surgical management of miscarriage
what is the teaming of a septic miscarriage?
anti biotics + hysterectomy (removal of uterus)
what is the presentation of a spontaneous miscarriage?
vaginal bleeding
pain
open cervix (+/-)
what are the different types of spontaneous miscarriages?
threatened inevitable incomplete completed septic
mild bradycardia is common in which situations?
occiput posterior or transverse presentations
postdate gestation
what is the normal heart rate range for a foetus?
110-160bpm
what is defined as severe foetal bradycardia?
heart rate below 80bpm for > 3 mins
what are the causes of severe foetal bradycardia?
cord prolapse over twisted cord maternal seizure placental abruption prolonged cord compression epidural and spinal anaesthesia rapid foetal descent
