S11C101 - Ectopic pregnancy and emergencies in the 1st 20w of pregnancy Flashcards
1
Q
Risk factors for ectopic pregnancy
A
- PID
- tubal surgery
- IUD
- assisted reproduction techniques
- previous ectopic pregnancy
2
Q
serum bHCG
A
- virtually 100% sensitive
- should double about every 2d, if it takes longer this is indicative of pathology (ectopic)
- also, HCG levels that fall by
3
Q
Occurrrence of heterotopic pregnancy
A
1 in 30,000 pregnancies
- combined IUP and ectopic pregnancy
- much higher incidence with IVF
4
Q
Rh factor
A
- Rh D antigen can be detected at 5.5w GA
- alloimmunization can occur with as little as 0.1ml of fetal bood mixing with mom’s
- circulating blood volume of fetus is
5
Q
75% of miscarriages occur before 8w GA
A
-true
6
Q
Miscarriage/Abortion: what to order
A
- bHCG
- CBC
- type, Rh, antibody screen
- u/a
7
Q
high bHCG
A
- advanced pregnancy
- multiple gestations
- gestational trophoblastic dz (molar pregnancy)
- ovarian tumor
8
Q
threatened abortion
A
-pregnancy-related bloody vaginal d/c or bleeding during first 1/2 of pregnancy w/o cervical dilatation
9
Q
inevitable abortion
A
-vag bleed and dilatation of Cx
10
Q
incomplete abortion
A
- passage of only parts of the products of conception
- usually b/w 6-14w of pregnancy
11
Q
complete abortion
A
-passage of all fetal tissue, including trophoblast and all products of conception before 20w of conception
12
Q
missed abortion
A
-fetal death at
13
Q
septic abortion
A
- evidence of infection during any stage of abortion
- tx: ampicillin/sulbactam 3g IV or clindamycin 600mg PLUS gentamicin 1-2mg/kg IV
14
Q
GTB - gestational trophoblastic dz
A
- molar pregnancy
- incomplete - some nonviable fetal tissue
- 1/1700 pregnancies
- can be malignant
- high bHCG levels
- causes 1st trimester bleeding in 75% of molar pregnancies
15
Q
Implantation bleeding
A
-occurs at 5-6w
