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Obstetrics > Early to Mid-trimester Complications > Flashcards

Early to Mid-trimester Complications Flashcards

1
Q

If an hCG is at 3500 you should see what on US? If you don’t see this, what is the indication?

A
  • See gestational sac
    -don’t see it then its likely the pregnancy is lost
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2
Q

Spontaneous abortion occurs what percent of clinically recognized pregnancies and why?

A

10-15%, usually chromosomal abnormalities

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3
Q

50% of pregnancies are lost in the first ____ days?

A

14

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4
Q

This type of abortion presents with spotting or profuse bleeding, a dull ache, with no fetal expulsion?

A

Threatened abortion

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5
Q

What is the treatment for threatened abortion?

A

Bed rest and monitoring

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6
Q

What is the definition of spontaneous abortion?

A

expulsion of all or some of conceptive material before 20 weeks

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7
Q

25-50% of this type of abortions end in pregnancy loss?

A

threatened

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8
Q

This abortion presents as cramping for 1 week, & partial cervical dilation?

A

Inevitable abortion

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9
Q

This abortion presents as expulsion of ALL products of conception, closed cervix, bleeding and contractions have stopped, and hCG is negative?

A

Complete abortion

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10
Q

This abortion presents with heavy bleeding, moderate cramping, boggy uterus, dilated cervix, and expulsion of SOME of conception remnants (can look like liver)?

A

Incomplete abortion

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11
Q

What is the treatment for incomplete abortion?

A

Misoprostol or surgery with D&C in 1st trimester or D&E in 2nd trimester

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12
Q

This abortion presents with a closed cervix, brown discharge, and means the fetus is dead inside the uterus; lasts about 6 weeks?

A

Missed abortion

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13
Q

What is the treatment for missed abortion

A

D&C in 1st
D&E in 2nd
Misoprostol which softens cervix to expel pregnancy

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14
Q

What is the diagnostic criteria for recurrent abortions?

A

2 or more abortions with US or pathology documentation; or 3+ spontaneous abortions

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15
Q

This type of abortion presents with a foul brown discharge, fever, chills, bleeding, CMT, and a closed cervix?

A

Septic

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16
Q

Treatment for septic abortion?

A

D&E with ABX
Hysterectomy if severe

17
Q

How is a possible threatened abortion evaluated?

A

Ultrasound

18
Q

What imaging test needs to be done to evaluate recurrent spontaneous abortions?

A

Hysteroscopy to evaluate the uterine cavity

19
Q

What is the treatment for cervical insufficiency?

A

Cerclage or cervical suture at 12-14 weeks

20
Q

When do you remove a cerclage?

A

36-38 weeks

21
Q

This is an implantation of a fertilized egg outside the uterus, & 80% are in fallopian tube ampulla due to tube occlusion?

A

Ectopic pregnancy

22
Q

These are risks for what condition: PID; Abdominal or tubal surgery; IUD; endometriosis; & assisted reproduction?

A

Ectopic pregnancy

23
Q

What is the triad for recognizing ectopic pregnancy?

A

Unilateral pelvic pain
Vaginal bleeding
Pregnancy

24
Q

Presentation: Shoulder pain, peritonitis, hypotension, tachycardia, bleeding, abdominal pain & syncope?

A

Ruptured ectopic pregnancy

25
Q

How can you diagnose an ectopic pregnancy via hCG?

A

It won’t increase like in a normal pregnancy

26
Q

If an hCG is >200 but there’s no gestational sac, what does this indicate?

A

The pregnancy is ectopic

27
Q

What test and image study are required for diagnosis of ectopic pregnancy?

A

hCG & Trans vaginal ultrasound

28
Q

What is the treatment for non-ruptured ectopic pregnancy?

A

Methotrexate because it destroys tissue and stops cells from growing

29
Q

Whats the treatment for a ruptured ectopic pregnancy?

A

1st line: laparoscopic salpingostomy to remove fertilized egg

30
Q

What should we always test for and consider giving if a patient experiences a spontaneous abortion or ectopic pregnancy?

A

Test Rh status
Administer RhoGAM

31
Q

What is the spontaneous premature dilation or shortening of the cervix in the2nd or early 3rd trimester?

A

Cervical insufficiency (also called cervical incompetence)

32
Q

Presentation: Painless dilation of >2cm and cervical effacement, bleeding, discharge and contractions?

A

Cervical insufficiency

33
Q

How do you dx cervical insufficiency?

A

TVU

Obstetrics (13 decks)

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