Obstetrics- Early Pregnancy Complications

Question 1

Management corpus luteum removal prior to 10wks gestation

Answer 1

Require post operative progesterone supplementation to prevent spontaneous abortion. Discontinue after 10 wks

Question 2

S&S hyperemesis gravidarum

Answer 2

Severe persistent nauseas and vomiting
Signs of dehydration 
>5% prepareg weight loss
Dizziness 
Orthostatic hypotension

Question 3

Evaluation os hyperemisis gravidarum

Answer 3

Differentiate from normal morning sickness with labs (electrolyte abnormalities and elevated AST/ALT)

Ketonuria on UA dictates admission and IV therapy or discharge with oral therapy

Question 4

interstitial ectopic pregnancy

Answer 4

upper outer corners of the uterus where the uterine wall meets the proximal Fallopian tubes. (aka Uterus cornua)

Question 5

Complication of ruptured corneal/ interstitial ectopic pregnancy

Answer 5

This region has abundant blood supply. Rupture leads to life- threatening intraabdominal hemorrhage, heavy vaginal bleeding and hemoperitoneum.

Question 6

Contraindication for methotrexate in ectopic pregnancy

Answer 6

Ruptured ectopic is a contra indication

Question 7

management of methotrexate for ectopic pregnancy

Answer 7

requires serial B-hCG levels until they become undetectable to ensure tx is complete and there is no longer risk for rupture