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Reproduction Week 1 2018/19 > 2: Care in early pregnancy > Flashcards

Flashcards in 2: Care in early pregnancy Deck (52)
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1

How long does an average pregnancy last?

40 weeks

2

Pregnancy is split into three trimesters.

When does each trimester start?

First trimester starts on day after last period

Second trimester starts at 13 weeks

Third trimester starts at 28 weeks

3

How is gestation (i.e the length of time a woman has been pregnant) estimated?

Simple timing using date of last period, current date

Ultrasound scan - distinct appearances during each trimester

4

Which hormonal marker confirms pregnancy?

ßhCG

5

What is the sample taken to test for pregnancy?

Urine sample

6

What is the most common symptom complained about at the beginning of pregnancy?

PV bleeding

Usually an implantation bleed (benign)

7

What are three abnormal outcomes of pregnancy?

Miscarriage

Ectopic pregnancy

Molar pregnancy

8

What is the difference between miscarriage and molar pregnancy?

Miscarriage - natural death of a viable embryo in early pregnancy

Molar pregnancy - implantation and subsequent death of non-viable embryo

9

What symptoms can accompany bleeding in pregnancy?

Pain (abdominal cramps)

Hyperemesis (vomiting)

Dizziness / Syncope

10

What is the presentation of a miscarriage?

Bleeding +/- passed products

Abdominal/back pain - may be mistaken as period cramps

11

Which scan is used to check for an implanted embryo in suspected miscarriage?

Transvaginal ultrasound

12

In miscarriage, what is the initial abdominal pain compared to?

Period cramps

Must ask when last period was and do a urine pregnancy test

13

What is a rare complication of miscarriage which causes bradycardia and hypotension?

Cervical shock

Stimulation of the uterus by retained products causes vagal (parasympathetic) stimulation, causing a similar presentation to haemorrhagic or septic shock

14

What is the pathophysiology of miscarriage?

Bleeding > Impaired oxygen / nutrient supply to foetus > Foetal death

15

What is the os?

Passage between the vagina and the neck of the cervix

16

Women who have had a miscarriage should be scanned to check for which abnormal pregnancy?

Ectopic pregnancy

Because it's possible that they have an implanted embryo elsewhere and a ruptured ectopic is a medical emergency

17

What should you measure if a patient has been bleeding profusely e.g in miscarriage?

FBC

BP

HR

haemodynamics

18

In which four ways can a miscarriage be managed?

Conservative - watch and wait; natural expulsion

Medical - mifepristone > misoprostol to induce an abortion

MVA (manual vacuum aspiration)

Surgical removal of contents

19

Which autoantibody disease causes increased risk of thrombotic events and recurrent miscarriages?

Antiphospholipid syndrome

20

Which antibodies are raised in APS?

Anti-Lupus anticoagulant

Anti-cardiolipin

Anti-glycoprotein

21

How many miscarriages must a patient have to describe them as recurrent?

3+

22

What is an ectopic pregnancy?

Implantation of a fertilised egg outwith the uterus

23

Where do ectopic pregnancies most commonly occur?

Fallopian tubes

24

What is the presentation of an ectopic pregnancy?

Pain

+/- bleeding, dizziness, dyspnoea (due to internal bleeding)

25

Which form of referred pain may women with an ectopic pregnancy experience?

Shoulder tip pain

Unusual, cause not known

26

Recurrent pain in a pregnant women should be a red flag for which disease?

Ectopic pregnancy

27

Which imaging should be done for patients with suspected ectopic pregnancy?

USS

28

Which view is used in USS of pregnant women?

Transvaginal view

29

Which hormone should be tested for in any women who may be pregnant?

ßhCG

30

What is a pregnancy of unknown location?

Is it a definite diagnosis?

Elevated bhCG but can't find the embryo using ultrasound

No - wait and try again later