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Flashcards in Bleeding in early pregnancy Deck (19):
1

A women who is 9 weeks pregnant presents with some bleeding. On examination the cervix is closed and her uterus is the size you would expect for her gestation. What is the diagnosis?

Threatened miscarriage

2

A women who is 11 weeks pregnant present with lower abdominal pain and heavy vaginal bleeding with clots. You can hear the foetal heartbeat but on examination her cervix is open.

Inevitable miscarriage

3

A women who is 11 weeks pregnant present with lower abdominal pain and heavy vaginal bleeding with clots. You cannot hear the foetal heartbeat and on examination her cervix is open.

Incomplete miscarriage

4

A women who is 11 weeks pregnant presents with lower abdominal pain and heavy vaginal bleeding which has subsided by the time you see her. There is no foetal heartbeat and on examination her cervix is closed and her uterus is small.

Complete miscarriage

5

A women has had 3 miscarriages. What is the probability of a live birth in her next pregnancy.

40 - 50%

6

A women who is 11 weeks pregnant present with lower abdominal pain and heavy vaginal bleeding with clots. You can hear the foetal heartbeat but on examination her cervix is open. What is the treatment?

Inevitable miscarriage. Let the uterus exacuate itself, give pain relief.
If needed give an oxytoxic and evacuate the uterus surgically.

7

What does an HCG level that is rising by less than 66% over 48 hours possibly indicate?

Ectopic pregnancy

8

A 20 year old girl is in a & e with symptoms of shock.. She describes abdominal and shoulder tip pain.

Ectopic pregnancy

9

What cells produce HCG?

Trophoblast cells

10

What day after conception can HCG be detected?

~11

11

Describe how HCG levels increase in a healthy pregnancy

They double every 48 - 72 hours, peaking between 8 and 11 weeks and then plateau or decline for the rest of the pregnancy.

12

What is the first test you would do if you suspected an ectopic pregnancy?

Transvaginal ultrasound

13

You suspect an ectopic pregnancy in a young women but the transvaginal ultrasound was not conclusive. What test could you do?

Laprascopy

14

What drug treatment is given in an early but growing ectopic pregnancy that is 2.5cm in diameter?

IM methotrexate

15

On trans vaginal US you see a lady has a 6cm ectopic pregnancy in her fallopian tube. What is the treatment?

Laproscopic salpingectomy

16

A 27 year old women presents with vomitting. She has had a positive pregnancy test but there is no foetal heartbeat. You do an US scan and you see a snowstorm pattern. Her HCG levels are very high.

Hydatidiform mole

17

Briefly describe what causes a complete hydatiform mole

One sperm combines with an egg that has lost its DNA. This causes the sperm to reduplicate.

18

In a partial or complete hydatiform mole more likely to become malignant?

Complete

19

What would you be suspicious of if a women had very high serum HCG levels?

Hydatiform mole