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Pregnancy Complications Flashcards

1
Q

What is a threatened and inevitable miscarriage?

A

threatened is when closed cervix on speculum exam

inevitable is when open cervix with bleed +/- clots

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2
Q

aetiology of spontaneous miscarriage? (5)

A 
abnormal conceptus
uterine abnormality
cervical incompetence
maternal (age, diabetes)
unknown
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3
Q

Ectopic pregnancy risk factors? (3)

A

PID
assisted conceptions
previous tubal surgery

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4
Q

Presentation in ectopic pregnancy?

A

period of amenorrhoea, bleeding, pain, GI or Urinary symptoms

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5
Q

Investigations in ectopic?

A

no intrauterine gestational sac
fluid in recto-uterine pouch
serum BHCG levels
progesterone levels

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6
Q

Management in ectopic?

A

methotrexate
surgical
conservative

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7
Q

what is Antepartum Haemorrhage?

A

haemorrhage from the genital tract after the 24th week of pregnancy but before delivery of baby

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8
Q

what is placenta praevia?

A

all parts of the placenta implants in the lower uterine segment

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9
Q

placenta praaevia more common in? (3)

A

multiparous women
multiple pregnancies
previous caesarean

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10
Q

placenta praaevia presentation?

A

painless PV bleeding
malpresentation of fetus
incidental

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11
Q

clinical features in placenta praaevia?

A

soft, non tender uterus +/- fetal malpresentation

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12
Q

whats important in placenta praevia?

A

NO vaginal examination

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13
Q

medical management of PPH?

A 
oxytocin
ergometrine 
carbaprost
tranexamic acid
balloon tamponade
surgical
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14
Q

what is placental abruption?

A

haemorrhage resulting from premature separation of the placenta before the birth of the baby

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15
Q

placental abruption risk factors?

A 
pre-eclampsia
multiple pregnancy
polyhydramnios
smoking
age
cocaine
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16
Q

PA presentation?

A

pain
vaginal bleeding
increased uterine activity

17
Q

PA management?

A

attempt vaginal delivery
CS if blood loss high
gestion
general condition of mother & baby

18
Q

PA complication? (3)

A

maternal shock
fetal death
PPH

19
Q

when is classed as preterm labour?

A

onset of labour before 37 complete weeks gestation

259 days

20
Q

RF for preterm labour?

A 
multiple
polyhydramnios
APH
pre-eclampsia
infection
unknown
21
Q

preterm labour diagnosis?

A

contractions with evidence of cervical change on vaginal examination

22
Q

causes of neonatal morbidity?

A 
resp distress
intraventricular haemorrhage
cerebral palsy
nutrition
infection
visual impairment
hearing loss
23
Q

Pre-Eclampsia diagnosis? (2)

A

mild HT on two occasions more than 4hrs apart

moderate to severe HT with proteinuria of more than 300mgms/24hrs

24
Q

Pre-Eclampsia RF?

A 
first pregnancy
extreme maternal age
BMI >35
FH
underlying medical
multiple pregnancy
25
Q

Pre-Eclampsia maternal complications?

A 
seizures
cerebral haemorrhage/stroke
HELLP
DIC
renal + cardiac failure
pulmonary oedema
26
Q

Pre-Eclampsia fetal complications?

A

impaired placental perfusion
intrauterine growth restriction
prematurity
increased PN mortality

27
Q

Signs and symptoms of severe pre-eclampsia? (7)

A 
headache
blurred vision
epigastric pain
rib pain
vomiting 
swelling of hands face/legs
clonus with brisk refelexes
28
Q

Biochemical in pre-eclampsia? (5)

A 
raised liver enzymes
bilirubin
urea
creatinine
urate
29
Q

Haematological in pre-eclampsia? (3)

A

low platelet
haemoglobin
increased haemolysis

30
Q

Eclampsia treatment?

A

magnesium sulphate bolus + IV infusiion

control BP with IV label

31
Q

Pre-eclampsia prophylaxis?

A

Aspirin from 12 weeks of next pregnancy

32
Q

Insulin requirements of the mother increase due to anti-insulin affects of? (4)

A

human placental lactose
progesterone
HCG
cortisol

33
Q

what is fatal hyper-insulinemia?

A

glucose crosses the placenta and induces increase insulin in fetes which causes macrosomia

34
Q

screening for gestational diabetes?

A

offer HbA1C at booking

75g OGTT to be done and repeat 24-28w

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