Pregnancy Loss, Ectopic Pregnancy and Rh Disorders Flashcards
what is the discriminatory level of hCG in which you will see a gestational sac
1500-2000
What change in hCG levels over what period would confirm abnormal IUP or ectopic pregnancy
increase of 53% or less over 48hrs
What is the initial spontaneous abortion rate in clinically recognized pregnancies
10-15%
After 8 weeks an US is performed and it reveals a normal size fetus with an appropriate heart beat, what is the percent risk of fetal loss
2%
What is the most common class and specific disorder of SAB?
Chromosomal trisomies
trisomy 16
Describe a threatened abortion
Vaginal bleeding with a closed cervix
25-50% eventually result in loss of pregnancy
treatment is expected management
Describe inevitable abortion
Vaginal bleeding & cervix is partially dilated
loss is inevitable
Describe incomplete abortion
Vaginal bleeding, crampin, abdominal pain, dilated cervix
Passage of some but not all products of abortion
treatment is suction D&C
Describe complete abortion
Passage of all products of conception
pain, bleeding, and pregnancy symptoms resolve
Describe missed abortion
fetus expired and remains
Can lead to coagulation or septic abortion
Describe septic abortion
Fever, uterine discharge with tenderness
Start IV abx
Proceed with suction D&C
what constitutes recurrent abortions
3 successive SAB
Excludes ectopic
What are the 5 etiologies of recurrent abortions
- General maternal factors
- Local Maternal Factors
- Fetal Factors
- Chromosomal factors
- Immunologic Factors
What are the areas of general maternal factors that can lead to SAB
Infection
Smoking and EtOH
Medical disorders (Diabetes, HTN, SLE)
Maternal Age
What are areas of local maternal factors that lead to SAB
Uterine abnormalities
- DES exposure
- Submucosal fibrinoids
Cervical incompetence
- painless dilation and delivery
- Treat with cervical cerclage
How does ART influence ectopic pregnancy.
Increases the likelihood of having ampullary or heterotopic pregnancy
What are some risk factors for ectopic pregnancy
Tubal infection (chlamydia, gonorrhea)
Previous ectopic
IUD
IVF or ART
What is the classic triad of ectopic pregnancy
prior missed menses
vaginal bleeding
lower abdominal pain
what pharm agent should be given to women with unruptured ectopic
Methotrexate.
BE GONE TUMOR BABY
What is a salpingectomy
entire fallopian tube removed
What is a salpingostomy
incision made laterally over the area of enlarged tube
can a baby be affected by isoimmunization post partum?
Yes!
What are characteristics of fetal hydrops
ascites
pleural effusion
Pericardial effusion
Polyhydramnios
