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Gynaecology > Early pregnancy > Flashcards

Early pregnancy Flashcards

1
Q

What is miscarriage?

A

Spontaneous loss of pregnancy before 24w

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2
Q

What is the incidence of miscarriage?

A

15% in all women (higher in older women)

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3
Q

What are the S/S of miscarriage?

A

Fever
Abdominal pain
Bleeding
Tissue mass

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4
Q

What are the causes of miscarriage?

A 
FETAL: chromosomal abn
MATERNAL (CU MAGIC)
1) Anatomical: cervical incompetence, uterine abn
2) Functional
- Metabolic: endocrine, nut
- AI: SLE, APLS
- Gen: S/D/SA, radiation
- Inf: 
- Chronic debilitating disease
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5
Q

How to Ix miscarriage?

A

Blood: CBC, x match, Rh
USG: normal (IU pregnancy & viability), abn (trilaminar appearance, heterogenou IU material)
hCG: decline

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6
Q

How to Mx complete miscarriage?

A

Psychological support

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7
Q

How to Mx incomplete miscarriage?

A

Expectant
Medical: misoprostol
Surgical: EVA, MVA

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8
Q

What is ectopic pregnancy?

A

Implantation outside uterine cavity

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9
Q

What is the MC site of ectopic pregnancy?

A

Fallopian tbe (ampulla)

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10
Q

What are the RF of ectopic pregnancy?

A

Smoking
Gyn: Hx of ectopic pregnancy, tubal surg, PID
Obs: conception by ART
Iatrogenic: IUCD, progesterone

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11
Q

What are the S/S of ectopic pregnancy?

A

Acute pelvic pain after amenorrhea
PPT w/ normal sized uterus
Scanty vaginal bleeding
Shoulder tip pain

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12
Q

How to Ix ectopic pregnancy?

A 
PPT
TVS: empty uterus (trilaminar), pouch of douglas (adnexal mass as tubal ring, free fluid), pseudo-GS (x double rim, x yolk sac)
hCG x2 (in 48hr): suboptimal rise
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13
Q

How to Mx ectopic pregnancy?

A

Expectant (may resolve spontaneously)
Medical: MTX
Surg: laparoscopy (salpingectomy, salpingostomy)

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14
Q

What is spontaneous miscarriage?

A

Miscarriage before 20w

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15
Q

What is threatened miscarriage?

A

Vaginal bleeding before 24w

Os closed

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16
Q

What is inevitable miscarriage?

A

Bleeding + opened os

17
Q

What is silent miscarriage?

A

x bleeding or S/S

USG: empty/small IU sac, non viable fetus

18
Q

What is early fetal demise/delayed miscarriage?

A

Implantation but x fetal dev

19
Q

What is incomplete miscarriage?

A

Retained products of gestation

20
Q

What is complete miscarriage?

A

x retained products of gestation

21
Q

What is recurrent miscarriage?

A

3 consecutive miscarriages

22
Q

How to Ix recurrent miscarriage?

A

Hx & PE: cervical incompetence
Blood: plt, APLS (AC, LA), SLE (anti-dsDNA), TFT
Genetic test: parents, POC
Imaging: 2D pelvic USG, 3D pelvic USG +/- salinography
Chorioamnionitis (during 2nd trimester): HVS x culture

23
Q

How to Mx cervical incompetence?

A

Elective cerclage (pre-conception or 2nd trimester)

24
Q

How to Mx APLS?

A

LD aspirin + PPX LMWH

Gynaecology (4 decks)

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