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3 Reproduction and Sexual Health > Bleeding in Early Pregnancy > Flashcards

Bleeding in Early Pregnancy Flashcards

(70 cards)

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1
Q

Ix for miscarriage patient

A 
ensure they're haemodynamically stable
FBC
G+S
bHCG
USS
histology
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2
Q

Tx of miscarriage

A 
conservative
manual vacuum aspiration 
surgical
emotional support - partner too!
anti-D administration if lacking
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3
Q

when does the 1st trimester complete?

A

13 weeks

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4
Q

when does the 2nd trimester complete?

A

28 weeks

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5
Q

when does the 3rd trimester complete?

A

40 weeks

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6
Q

the embryo is normal in miscarriage T or F

A

T

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7
Q

what investigation should be done after 3rd miscarriage?

A

genetic testing

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8
Q

how many miscarriages are classified as recurrent miscarriage?

A

3

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9
Q

what conditions can cause recurrent miscarriage?

A

antiphospholipid system
thrombophilia
balanced translocation
uterine abnormality

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10
Q

when does miscarriage tend to occur if someone has a uterine abnormality?

A

late in 1st trimester

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11
Q

define threatened miscarriage?

A

risk to pregnancy

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12
Q

define inevitable miscarriage

A

pregnancy cant be saved

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13
Q

define incomplete miscarriage

A

part of pregnancy lost already

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14
Q

define complete miscarriage

A

all of pregnancy lost, uterus empty

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15
Q

what is early foetal demise?

A

pregnancy in situ but not heartbeat

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16
Q

most common site for ectopic pregnancy?

A

fallopian tube

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17
Q

what scar site is a particular location for ectopic preganncy?

A

previous CS scar

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18
Q

is bleeding or pain the more common symptom in ectopic pregnancy?

A

pain

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19
Q

dull pain, dizziness, nausea, short of breath, collapse, cant lie down without catching breath….

A

suspect ectopic pregnancy; internally bleeding but still coping

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20
Q

why do patients with ectopic pregnancies have trouble with breathing lying down

A

internal blood irritates the diaphragm

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21
Q

other potential sites for ectopic pregnancy?

A 
ovary
peritoneum
liver
cervix
CS scar
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22
Q

signs of ectopic pregnancy on examination?

A 
pallor
haemodynamically unstable
peritonism
guarding
tenderness
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23
Q

Ix for ectopic pregnancy?

A

FBC
G&S
bHCG
USS

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24
Q

USS findings of ectopic pregancy?

A

empty uterus/pseudo sac
mass in adenexa (tube)
free fluid in pouch of douglas

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25
when should serum HCG be assessed in a suspected ectopic?
assess 48 hours apart if haemodynamically stable
26
if you cant find the pregnancy (pregnancy of unknown location (PUL)) what is the cause?
pregnancy is already lost (waiting for bHCG to lower) waiting for a pregnancy to evolve within the womb potential ectopic
27
how is the severity of an ectopic determined?
symptoms USS findings SEWS
28
when would you do surgery in an ectopic?
if patient is acutely unwell
29
when would you medically manage an ectopic?
if bHCG is <1000 if patient is stable if ectopic is small and unruptured
30
medical management of an acute ectopic?
methotrexate + gefitinib
31
what is a molar pregnancy?
overgrowth of placental tissue and an unviable fertilised egg
32
what condition presents with "grape like clusters" on placenta? why is this?
molar pregnancy | chorionic villi of the placenta become swollen with HCG
33
"snowstorm appearance" of placenta on USS?
complete mole
34
patients with a complete mole are at risk of what cancer?
choriocarcinoma
35
symptoms of molar pregnancy?
hyperemesis varied bleeding passage of grapelike tissue SoB occasionally
36
Ix of molar pregnancy?
USS | take tissue for histology
37
Tx of molar pregnancy?
surgical | follow up with molar pregnancy services
38
timing of implantation bleeding?
10 days post ovulation
39
colour of implantation bleeding? how much is there?
light brown | limited
40
where is the blood in a chorionic haematoma?
between endometrium and embryo due to separation (subchorionic)
41
cervical cancer can be shown with what stain? what colour does it go?
stains white on acetoacetic acid
42
symptoms of a chorionic haematoma
bleeding | cramping
43
Tx of chorionic haematoma?
self limiting
44
what should be ruled out in a patient with suspected PV bleeding?
exclude urinary/faecal causes eg UTI
45
miscarriage has more bleeding or pain usually?
bleeding
46
what is pain like in miscarriage
varied intensity and frequency depending on stage
47
what does rhesus negative mean? what implication does this have for pregnancy?
you dont contain anti-D on your red blood cells | at risk of miscarriage
48
when does morning sickness become HG?
if its excessive, protracted and affects quality of life
49
symptoms of HG?
``` dehydration ketosis electrolyte/nutrition imbalance weight loss - malnutrition altered liver function mental health issues ```
50
cervical causes of bleeding in early pregnancy?
ectopy infection eg chlamydia, gonorrhea, bacterial polyp malignancy
51
Tx of HG?
``` rehydration IV antiemetics electrolyte replacement nutrition vitamins eg thiamine thromboprophylaxis ToP if severe ```
52
non gynae causes of sickness?
``` urosepsis in UTI gastritis peptic uler viral hepatitis pancreatitis ```
53
how do you diagnose HG?
exclude other causes of sickness
54
vaginal causes of bleeding
``` trichomoniasis bacterial vaginosis chlamydia malignancy forgotten tampon ```
55
bowel causes of bleeding?
UC haemarrhoids malignancy
56
pharmacological Tx of HG?
1. cyclizine/prochlorperaxine | 2. ondansetron/metoclopramide
57
HG tends to end by what trimester?
1st
58
embryo is normal/abnormal in molar pregnancy?
abnormal
59
a patient who is bleeding in early pregnancy may present with what other symptoms?
pain hyperemesis dizziness fainting
60
pregnancy test is positive in miscarriage T or F
T
61
symptoms of miscarriage
BLEEDING cramping passed products eg issue
62
what is fundal height?
mother's uterus to the top of the mother's pubic bone in cm
63
what is the external os?
the opening of the cervix
64
the external os is ____ in threatened miscarriage
closed
65
the external os is ___ in inevitable miscarriage
open
66
if the miscarriage products are in the vagina what kind of miscarriage is this?
complete
67
what infections can cause miscarriage?
CMV rubella toxoplasmosis listeria
68
pathophysiology of miscarriage
unclear | bleeding from placental bed or chorion causes hypoxia and villous/placental dysfunction
69
foetal pole is under _mm in early foetal demise
7
70
mean sac diameter is under _mm in early foetal demise
25

3 Reproduction and Sexual Health (51 decks)

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