Pregnancy complication

Question 1

Pre-eclampaisa

Answer 1

Caused by precental ischema due to impaired vasodilation of spiral arteries, resulting in vascular tone.

1) HTN
2) proteinuria
3) edema

Can be associated with HELLP syndrome

Question 2

Eclampsia

Answer 2

Preeclapmsia + seizures

Question 3

Preeclampsia prevalence

Answer 3

7% in preg from 20 wks gestation to 6wks postpartum,
- Before 20 wks suggests molar pregnancy

Increased risk if preexisting HTN, DM, CKD, autoimmne.

Mortality due to cerebral hemorrhage, ARDS

Question 4

HELLP syndrome

Answer 4

Hemolysis
Elevated liver enzyme
Low Platelets

Question 5

Abruptio placentae

Answer 5

Premature (abrupt) detachment of placenta from implantation site.

Presentation: painful bleeding in 3rd trimester.

Associated with DIC, diffuse cortical necrosis of kidney
Increased risk with smoking, HTN, cocaine

Life threatening to both fetus and mother.

Question 6

Placenta accreta

Answer 6

Defective desidual layer
placenta attached to myometrium, no separation after birth.

Presentation: massive bleeding after delivery

Increased risk with prior C section, inflam, placenta previa.

“Accreta=encased in=encased in myometrium”

Question 7

Placenta previa

Answer 7

Attachment of placenta to lower uterine
Lies near or extends over internal cervical os

Presentation: painless bleeding in any trimester

Increased risk with multiparity and prior C section

Question 8

Retained placental tissue

Answer 8

May cause pospartum hemorrhage;

increased risk of infection

Question 9

Ectopic pregnancy

Answer 9

Often in fallopian tube, suspect with history of amenorrhea
Lab: lower than expected bHCG and sudden lower abd pain, confirm with ultrasound
Pain with or without bleeding

Mistaken for appendicitis.

Question 10

Ectopic pregnancy biopsy

Answer 10

Endometrial biopsy showing desidualized endomertrium but no chorionic villi, which develop only in intra-uterine pregnancy.

Question 11

Ectopic pregnancy risk factors

Answer 11

1) history of infertility
2) salpingitis (PID)
3) rupture appendix
4) prior tubal surgery.

Question 12

Amnionic fluid abnormality:

polyhydroamnios

Answer 12

> 1.5 to 2L of amniotic fluid,
associated with esophagel/duodenal atresia, anencephaly
inability to swallow amniotic fluid

Question 13

Amnionic fluid abnormality:

oligohydramnios

Answer 13

s syndrome.