Pregnancy Complications Flashcards
Complete abortion
Complete expulsion of all products of conception before 20 weeks
Complete abortion tx
None
Incomplete abortion
Partial expulsion of some but not all POC before 20 weeks
Incomplete abortion tx
D&C
Prostaglandins
Inevitable abortion
No expulsion of products but vaginal bleeding and dilation of cervix
Inevitable abortion tx
Prostaglandins
Missed abortion
Death of embryo or fetus before 20 weeks with complete retention of all POC
Missed abortion tx
Prostaglandins
D&C
Threatened abortion
Any vaginal bleeding before 20 weeks without dilation of cervix
Threatened abortion tx
Monitor closely
MC location for ectopic
Ampulla
S/S of ectopic pregnancy
Amenorrhea
Vaginal bleeding
Lower abdominal pain
Adnexal mass
HCG of ectopic
Does not double every 48 hours as it should
Diagnosis of ectopic pregnancy
US
Tx of ectopic pregnancy
Methotrexate
Surgical removal
Complete mole
46, XX, or XY
Both sets of chromosomes are paternal
S/S of complete mole
Vaginal bleeding
Large for date
HCG over 100,000
Diagnosis of complete mole
Snowstorm on US
Incomplete mole
69, XXX, or XXY
Two paternal haploid sets and one maternal
Diagnosis of incomplete mole
Thickened multicystic placenta
S/S of incomplete mole
Missed abortion
Small for date
Management of molar pregnancy
D&C
Pitocin and Rhogam should be given
Goals for glucose control in gestational diabetes
Preprandial 70-100
Postprandial 100-129
A1C < 7
Glucose challenge test
1 hour test between 24-28 weeks
Then 3 hour if positive
Treatment of gestational DM
First diet modification and exercise
Metformin
Insulin
When is elective c-section considered for gestational DM?
Weight > 4500g
Risks of gestational DM
Stillbirth
Macrosomia
Obesity
Risk factors for cervical insufficiency
D&C
Conization
LEEP
US of cervical insufficiency
Cervix shorter than 2.5 cm
When is cerclage placed?
Rescue: up until 24 weeks
Elective: 12-14 weeks
MCC of third trimester bleeding
Placental abruption
S/S of placental abruption
Painful vaginal bleeding
S/S of placenta previa
Painless vaginal bleeding
Diagnosis of placenta previa
TV US
Preeclampsia
Onset of hypertension and proteinuria after 20 weeks
SBP > 140 OR DBP > 90
Proteinuria of >/= 0.3 g in 24 hour urine specimen
Eclampsia
Occurrence of generalized convulsion in the setting of preeclampsia
HELLP syndrome
Hemolysis
Elevated liver enzymes
Low platelets
Definitive treatment of preeclampsia
Delivery
Primary prevention for preeclampsia
Magnesium sulfate
When are steroids given for preterm infants?
Before 28 weeks
Gestational HTN
HTN after 20 weeks
Treatment of gestational HTN
Labetalol
Methyldopa
Nifedipine
Reduce risk of preeclampsia
Low dose ASA
Rh incompatibility
Rh- mom and Rh+ baby
Result of Rh incompatibility
Hemolysis of fetal RBC leading to hydrops fetalis
Administration of Rhogam
28 weeks
Within 72 hours of delivery
S/S of choriocarcinoma
Irregular bleeding
Pelvic pain
Hx of molar pregnancy
Diagnosis of choriocarcinoma
US
Elevated HCG
CT
Treatment of choriocarcinoma
Chemo + hysterectomy
