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Gross but true (OBGYNE) > Complications of Pregnancy > Flashcards

Complications of Pregnancy Flashcards

1
Q

Symptoms include bright red, heavy bleeding, midline cramping, low back pain, expulsion of products of conception

A

spontaneous abortion

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2
Q

Symptoms include slight bleeding, abdominal cramping, cervical os is closed, no products of conception are passed

A

threatened abortion

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3
Q

Symptoms include moderate bleeding, uterine cramping, cervical os is dilated, products of conception aren’t passed but passage is inevitable

A

inevitable abortion

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4
Q

Symptoms include heavy bleeding, abdominal cramping, low back pain, dilated cervical os, some portion of conception products remain in uterus

A

incomplete abortion

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5
Q

Symptoms include bleeding, abdominal cramping, low back pain, expulsion of fetus and placenta

A

complete abortion

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6
Q

Pregnancy ceased to develop, but products of conception have not been expelled. Brownish vaginal discharge but no free bleeding. Pain doesn’t develop

A

missed abortion

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7
Q

Management of a patient with a threatened abortion

A

Bed rest from 24 - 48 hours with gradual resumption of usual activities

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8
Q

Management of patient with missed, inevitable, incomplete abortion

A

counseling, assess Rh factor, plan for elective termination

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9
Q

Most common location for ectopic pregnancy

A

fallopian tube

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10
Q

Major cause of maternal death during the 1st trimeseter

A

ectopic pregnancy

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11
Q

A synthetic form of estrogen. Women exposed to this as a fetus have increased risk of breast CA

A

Diethylstilbestrol (DES)

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12
Q

Symptoms include 1-2 months amenorrhea, morning sickness, breast tenderness, diarrhea, sudden, severe pelvic pain that tends to be lateralized. Referred pain to shoulder

A

ectopic pregnancy

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13
Q

Pelvic exam reveals: Normal appearing cervix, marked tenderness. Vaginal vault may be bloody, usually brick red to brown in color. Tender adnexal mass may be palpated

A

ectopic pregnancy

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14
Q

What lab result will be lower than expected for an ectopic pregnancy?

A

B-hCG

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15
Q

virtually diagnostic of an ectopic pregnancy

A

hCG level of 6,500mU/ml with an empty uterine cavity by U/S

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16
Q

given systemically as a single dose or multiple doses, is acceptable medical therapy for EARLY ectopic pregnancy and hemodynamically stable

A

methotrexate

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17
Q

Most common type of gestational trophoblastic disease

A

hydatidiform mole

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18
Q

Benign neoplasm of the chorion in which chorionic villi degenerate and become transparent vesicles containing clear, viscus fluid. Occurs when a single sperm fertilizes an egg without a nucleus

A

hydatidiform mole

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19
Q

Which type of hydatidiform mole has a tendency to become choriocarcinoma?

A

complete

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20
Q

Symptoms include vaginal bleeding, enlarge uterus, pelvic pain, anemia, theca lutein cysts, hyperemesis gravidarium, no fetal heart tones/activity

A

hydatidiform mole

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21
Q

What happens to the B-hCG with hydatidiform mole?

A

extremely high for gestational age

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22
Q

On ultrasound there is absence of gestational sac and Characteristic multiple echogenic region “snowy” within the uterus.

A

hydatidiform mole

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23
Q

Where does hydatidiform mole metastases to?

A

lungs. get CXR

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24
Q

Treatment for hydatidiform mole

A

D & C immediately. Pathologic exam on curettings.

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25
Q

How often do you follow B-hCG with hydatidiform mole?

A

weekly. after two decreasing weekly test can check monthly for six months then every 2 months for one year

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26
Q

Treatment of choice for choriocarcinoma

A

Highly sensitive to chemotherapy

27
Q

What do the following have in common: implantation, ectopic pregnancy, impending/complete abortion, cervical/vaginal/uterine pathology?

A

major causes of first trimester bleeding

28
Q

Placenta implanted in lower segment of the uterus and extends over or lies proximal to the internal cervical os

A

placenta previa

29
Q

Symptoms include painless bright red bleeding in 3rd trimester, may have shock symptoms, VS and FHT stable

A

placenta previa

30
Q

Absolutely contraindicated in placenta previa due to potential to bleed out

A

vaginal or speculum exam. diagnosed with US

31
Q

Management of placenta previa

A

IV fluids and Magnesium sulfate and corticosteroids if in labor and < 34 weeks

32
Q

Partial or complete detachment of a normally implanted placenta at any time prior to delivery. Often during 3rd trimester. Significant cause of mortality

A

Abruptio Placentae (placental abruption)

33
Q

Major risk factor for abruptio placentae

A

smoking

34
Q

Symptoms include vaginal bleeding, abdominal pain, uterine contractions/tenderness, nonreassuring FHT

A

Abruptio Placentae (placental abruption)

35
Q

What do all pregnant women with abdominal pain, uterine contractions and vaginal bleeding need to have ruled out?

A

Abruptio Placentae (placental abruption)

36
Q

How is Abruptio Placentae (placental abruption) diagnosed?

A

ultrasound-retroplacental hematoma

37
Q

the placenta attaches itself too deeply into the wall of the uterus.

A

Placenta Accretas

38
Q

associated with a history of prior cesarean section, history of uterine instrumentation or surgery, or placenta previa

A

placenta accretas

39
Q

Risks associated with placenta accretas

A

preterm delivery and severe postpartum hemmorrhage

40
Q

Treatment for placenta accretas

A

Monitor pregnancy with the intent of scheduling a delivery and using a surgery that may spare the uterus

41
Q

Persistant, severe, intractable vomiting during pregnancy. Peak incident is 8-12 weeks. Should resolve by 20 weeks

A

Hyperemesis Gravidarum

42
Q

Management of a patient with Hyperemesis Gravidarum

A

hospitalization w/bed rest, NPO x 48hrs. Place patient on dry diet as soon as possible

43
Q

First line medication for Hyperemesis Gravidarum

A

Pyridoxine (Vitamin B6)

44
Q

Defined as the presence of elevated blood pressure and proteinuria during pregnancy. Caused by widespread vascular endothelial dysfunction and vasospasm

A

preeclampsia

45
Q

What are the three classic elements required for preeclampsia?

A

HTN, proteinuria, edema

46
Q

When can preeclampsia-eclampsia occur?

A

anytime after 20 weeks of gestation and up to 6 weeks postpartum

47
Q

What is unusual about the thromboxane and prostacycline levels in preeclampsia-eclampsia?

A

Placenta produces 7x more thromboxane than prostacycline. Normally they are equal

48
Q

Management of preeclampsia at 36 weeks regardless of severity or lack thereof

A

delivery

49
Q

Management of mild preeclampsia

A

bed rest, low dose ASA, hydralazine or methyldopa to reduce BP

50
Q

Quantification of severe preeclampsia

A

B/P: ≥ 160 systolic or ≥ 110 diastolic. Proteinuria: ≥ 500mg/24 hours or 4+ on dipstick. Oliguria of < 500ml/24hrs. Thrombocytopenia

51
Q

What is HELLP syndrome seen with severe preeclampsia?

A

hemolysis, elevated liver enzymes, low platelets

52
Q

Abnormalities of peripheral smear with HELLP

A

burr cells and schistocytes

53
Q

Symptoms include: epigastric pain, nausea, RUQ tenderness, edema

A

HELLP

54
Q

When does preeclampsia become eclampsia?

A

presence of seizures

55
Q

Given to control seizure activity when treating eclampsia

A

Mg sulfate

56
Q

Signs of Mg toxicity

A

decreased DTRs, respiratory rate/depth

57
Q

How do you reverse Mg toxicity?

A

Calcium gluconate

58
Q

labor that begins before the 37th week of pregnancy

A

preterm labor

59
Q

Can indicate patients at risk for preterm labor. Retrieved from cervix. It’s presence in the 2nd or 3rd trimester is a serious warning of PTL

A

Fetal fibronectin

60
Q

Pharmacological treatment for preterm labor that can be safely halted

A

tocolytics

61
Q

Visualization of fluid in the vagina of a pregnant women who presents with a history of leaking fluid

A

rupture of the membranes

62
Q

Ferning patterns for amniotic and cervical mucous

A

amniotic = delicate fern pattern. cervical = dense and thick fern pattern

63
Q

at higher risk of neonatal hypoglycemia, hyperbilirubinemia, hypocalcemia and polycythemia

A

newborn of DM mother

64
Q

Effect of pregnancy on maternal thyroxine requirements

A

increase in women with hypothyroidism diagnosed prior to pregnancy

Gross but true (OBGYNE) (17 decks)

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