SAB and Ectopic Flashcards
causes of bleeding 1st trimester
implantation bleeding subchorionic hemorrhage miscarriage ectopic cervical infection (cervicitis) trauma
how is subchorionic hemorrhage dx/ is it benign or not
ultrasound
benign
most common cause of early abortion
chromosomal abnormality
most frequent anomaly abortion in 1st trimester
autosomal trisomy
second most common cause of 1st trimester abortion
monosomy x
when does aneuploid and euploid abortions peak
aneuploid = 8wks euploid= 13 wks
ashermans sydrome
intrauterine adhesions
what percent of ectopics are tubal
95%
standard tx for ectopic pregnancy
surgery
medication criteria for ectopic pregnancy abortion
tubal ectopic no larger than 3.5 cm (drugs wont work on it)
no cardiac activity present
hemodynamically stable pt
no signs of intrabdominal bleeding
hCG < 15000 units (2 hCG tests)
no contraindications to methotrexate (get liver function)
how should norma hCG rise
53% or more in 48 hours and double in 72 hours.
what does it mean if hCG is falling
Falling or plateauing hCG is always abnormal but not always an ectopic pregnancy
drug management for ectopic
methotrexate (50mg per meter square of body surface)
recheck hCG at days 3,7,14
should progressively fall (flat or rising levels indicate failure)
what medications prevent pre term birth
tocolytics
examples of tocolytics
Beta adrenergics (Terbutaline) - B2 relax uterus & vessels
*Magnesium sulfate (CCB)– smooth muscle relaxation
Indomethacin
Calcium channel blockers
Treatment failure: if cervix reaches 5cms
