REPRO 7 Flashcards
causes for bleeding in early pregnancy
molar pregnancy miscarriage implantation bleeding chorionic haematoma cervical, vaginal ectopic PR bleeding polyp
miscarriage os closed
os opened
threatened
inevitable
types of miscarriage
threatened, inevitable, complete/incomplete, silent (IUD)
treatment of miscarriage
if threatened - conservative
is others - medical/surgical
ectopic pregnancy where
tubes, ovary, peritoneum, liver, cervix, cs scar, PUL
symptoms of ruptured ectopic pregnancy
collapse pain > bleeding SOB dizzy shoulder tip pain peritonism - guarding and tender
ix for ectopic
FBC, group and save, HCG - double in 48 hours, cervical excitation
treatment of ectopic
surgery if rupture/collapse
other methotrexate
molar pregnancy what is it
gestational trophoblastic disease - overgrowth in placental tissue with chorionic villous swollen with fluid - grape like
complete molar pregnancy genetics
is there a risk
egg without maternal DNA YY/Y
2.5 % risk of choriocarcinoma
incomplete moral pregnancy genetics
is there a risk
haploid egg XYY may have fetus
no risk of cancer
symptoms of molar pregnancy
exaggerated pregnancy symptoms to due increased HCG. varied bleeding and passage of grape like tissue. large for dates. SOB
USS of molar pregnancy
snowstorm
treatment for molar
surgical
tissue for histology
implantation bleeding when
what does it look like
what can is be mistaken for
10days post ov
light browinish
occasionally mistaken for period
what is a chorionic haematoma
pooling of blood between endometrium and embryo due to separation - subchorionic
symptoms of chorionic haematoma
large
bleeding, cramps, threatened misc
infection, irritability, cramps, miscarriage
treatment of chorionic hamatoma
self limiting if small
large - reassure and survey
APH is when
bleeding >24 weeks
causes of APH
placental abruption, placenta praaevia, vasa praevia, placenta accepta, uterine rupture, local causes
40% idiopathic
commonest cause of APH
abruption
risks for placental abruption
PET, htn, trauma, smoking, amphetamines (cocaine), medical, polyhydraminos, multiple pregnancy, preterm, PROM, abnormal placenta
complication of PA
DIC
uterine tender/wooden hard and difficult to feel fatal parts
PA
abnormal CTG and fetal distress
PA, uterine rupture, VP
treatment for PA
steroids, deliver, anti D?
placental previa is what
placental partially or totally implanted in lower stein segment
till when can placenta prevue be monitored
<37 w as can just move
types of placenta preavia
major <=2cm from os or covering
minor >2cm from os
painless recurrent bleeding in third trim
malposition
PP
does PP have maternal pyrexia
no
what should not be done in PP and why
vaginal exam
risk of haemorrhage
treatment of PP
steroids. anti D. deliver <2cm at 38-39w
37-38 weeks if prior bleeding or suspected/confirmed accretta
placenta accreta
symp
placenta invades myometrium
severe bleeding. PPH
placental percetta
reached serosa
treatment for accretta/percetta
CSEc at 37-38w
hysterecomty
uterine rupture risk factors
prev c section
prev uterine rupture
symp of uterine rupture
blood
obstructed labour
fetal distress/IUD
treatment of uterine rupture
laparotomy/CS
what is vasa praevia
bleeding from fetal vessels that cross or are in close proximity to internal cervical os umbilical arteries
when can VP be dx
antenatally
symp of VP
rx
fetal distress
CS
local causes of APH symptoms and signs volume of blood pain? uterus? fetal distress? placenta placement?
small vol of blood painless uterien SNT no normal placenta placement
any history of acute bleeding 23-32w
24h blood free then dc
recurrent bleed >28w
min stay 72h
any bleed >32w
min stay 72h
