repro 5

Question 1

ectopic pregnancy

Answer 1

implantation at any site outside of the endometrium
increased risk PID, adhesions, IUD, endometriosis
pain, shock, vaginal bleeding, death

Question 2

ruptured ectopic

Answer 2

is an emergency

Question 3

early pregnancy

Answer 3

spontaneous abortion and miscarriage is common
common
foetal chromosomal abnormalities, maternal endocrine factors, physical uterus problems, maternal vasculature problems
infection

Question 4

late pregnancy

Answer 4

foetal death less common
interruption of blood flow - knots or compression of cord
implantation problems - previa (implants low over the os) , accrete , increta (invading into muscle wall) and percreta (implants through full thickness of the wall)
abruption which can be hidden or visible (where placenta pulls away from the implantation into the endometrium)
malperfusion - preeclampsia, smoking, infarcts

Question 5

twin pregnancy

Answer 5

monochorionic twin placentas have vascular anastomoses connecting twins circulations, there may include one or more arteriovenous shunts
if the shunts preferentially increase blood flow to one twin at the expense of the other, one twin is under-refused and the other is fluid overloaded
if severe, death of one or both foetuses

Question 6

dichorionic diamnionic

Answer 6

different amniotic sac and chorions

Question 7

monochorionic diamnionic

Answer 7

identical twins

Question 8

monochorionic mono amniotic twins

Answer 8

both babies are in the same sac

at risk of vascular anastomoses - where one twin may get more blood supply

Question 9

placenta infections

Answer 9

develop either by ascending through the birth canal, or by haematogenous spread

Question 10

ascending infections

Answer 10

predominantly bacterial, ascend through the os
localised infection in membranes
premature rupture and preterm delivery

Question 11

haematogenous infections

Answer 11

TORCH group

toxoplasmosis, Others (syphilis, listeria), Rubella, CMV, Herpes simplex

Question 12

preeclampsia and eclampsia

Answer 12

a systemic syndrome characterised by widespread maternal endothelial dysfunction in pregnancy with HTN, oedema and proteinuria
more common in first time others

Question 13

eclampsia

Answer 13

seizures/convulsions

Question 14

HELLP syndrome

Answer 14

variant of preeclampsia
microangiopathic haemolytic anaemia, raised LLFT, low platelets

harder to diagnose and has higher mortality rate

Question 15

cure for preeclampsia and HELLP

Answer 15

delivery

Question 16

gestational trophoblastic disease

Answer 16

tumour/tumour like condition with proliferation of placental tissue, either villous or trophoblastic

complete/partial hydatidiform moles, invasive mole, choriocarcinoma and placental site trophoblastic tumour
hydatidiform moles have increased risk of invasive mole (aka persistent trophoblastic disease)

Question 17

formation of molar pregnancies

Answer 17

complete mole - sperm fertilises empty egg, lead to large grape like structures. risk of developing into choriocarcinoma or persistent trophoblastic disease
partial mole - forms when two perm fertilise an egg with genetic information, light risk of persistent trophoblastic disease but not of choriocarcinoma
invasive mole - penetrates uterus wall and can embolism to lungs and other sites, responds when too cheomo
gestational choriocarcinoma

Question 17

formation of molar pregnancies

Answer 17

complete mole - sperm fertilises empty egg, lead to large grape like structures. risk of developing into choriocarcinoma or persistent trophoblastic disease
partial mole - forms when two perm fertilise an egg with genetic information, light risk of persistent trophoblastic disease but not of choriocarcinoma
invasive mole - penetrates uterus wall and can embolism to lungs and other sites, responds when too cheomo

Question 18

gestational choriocarcinoma

Answer 18

can occur after mole, miscarriage or pregnancy
haematogenous spread, lungs, vagina
response well to chemo - unlike non gestational choriocarcinoma