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Flashcards in bleeding in early pregnancy Deck (43)
1

what is the most common cause of bleeding in early pregnancy?

spontaneous miscarriage

2

pain -ve, bleeding not profuse, cervix closed. uterus = gestational age

threatened miscarriage

3

family history in threatened miscarriage?

positive

4

inevitable miscarriage is similar to ?

incomplete miscarriage.

5

what is different about inevitable and incomplete?

inevitable hass a positive family history

6

cervix in threatened miscarriage?

closed

7

cervix in an incomplete miscarriage? what may be seen?

open, products of conception may be seen.

8

lower abdominal pain, HEAVY bleeding (with clots and tissues), shock +ve, tenderness +ve, POC may be present in cervix

y

9

what is septic miscarriage?

infection following a miscarriage

10

family history in incomplete miscarriage?

-ve

11

bleeding in complete miscarriage?

cessation of bleeding

12

what is the size of the funds like?

smaller than gestational age

13

complete miscarriage, small abdomen, cervix closed, no bleeding

fh -ve

14

why would you do haemoglobin?

anaemia

15

what other investigations would you do?

blood group and Rh typing, B hCH pregnancy test

16

why do you do b hcg?

if a hyatidiform mole is suspected

17

if sepsis is present while pregnant, what is done?

elective cesarian section and blood culture

18

treatment of a threatened miscarriage?

reassure, rest, avoid sex

19

when would you give aspirin, heparin or prednisolone for APLS?

after the first trimester

20

inevitable miscarriage management?

allow uterus to evacuate itself. PAIN RELIEF, OXYTOLIC, evacuation of uterus

21

for an incomplete miscarriage, what do you do for shock?

blood transfusion. remove POC. bimanual compression of the uterus

22

septic miscarriage treatment?

evacuate, resucitate, shock management

23

if had 3 miscarriages, probability of live birth in next pregnancy will be 40-50 percent.

investigations such as karyotyping, GTT, t4 or tsh can be done.

24

does ectopic pregnancy cause bleeding?

yes

25

amenorrhoea - why?

patient is pregnant, corpus luteum maintaining pregnancy

26

where can you get referred pain to in ectopic pregnancy?

shoulder tip

27

woman, no period 2 months, lower abdominal pain, adenexal tenderness, CERVICAL EXCITATION (tenderness)
abdominal guarding, bulky uterus, shock and syncope (ruptured)

ectopic pregnancy

28

outcomes?

tubal abortion/tubal rupture

29

how do you investigate?

pregnancy test, serum bhcg, transvaginal US scan, diagnostic laparotomy

30

what is the treatment?

salpingectomy, IM methotrexate, conservative management

31

what do you do if its ruptured?

laparotomy

32

development anomaly of the trophoblast or placenta in which there is a local or general vesicular change in the chorionic villi?

hydatidiform mole

33

what appearance does it have on US?

snowstorm appearance

34

what does the uterus feel like?

doughy

35

name of the ovarian cysts?

theca lutein

36

why do you get weight loss and dehydration?

persistent vomiting (hyperemesis)

37

uterus larger than dates, doughy, amenorrhoea, persistent vomiting, vaginal bleeding

hydatidiform mole. increased pre eclampsia

38

what would you see on ultrasound?

snowstorm appearance and theca lutein ovarian cysts

39

there is a possibility of malignant change to choriocarcinoma. whats the treament?

evacuation of uterus, prolonged follow up, ***CONTRACEPTION to avoid pregnancy during follow up. hysterectomy if no desire for further childbearing. persistent disease requires chemotherapy.

40

Investigations?

urinary and b hcg levels

41

cervical cerclage, what is this? when is it usually down and when taken out?

stitches in the cervix. done at 14 weeks and removed at 36 weeks

42

cervix begins to dilate before pregnancy has reached term?

cervical incompitence. NO PAIN IN CERVICAL DILATION

43

what is the purpose of giving methotrexate in an ectopic pregnancy?

stops the growth of the fetus, can be done if surgery can't be performed immediately