Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

obs and gynae > Early pregnancy > Flashcards

Early pregnancy Flashcards

(70 cards)

Start Studying
1
Q

ectopic pregnancy definition

A

when a pregnancy is implanted outside the uterus. The most common site is a fallopian tube. An ectopic pregnancy can also implant in the entrance to the fallopian tube (cornual region), ovary, cervix or abdomen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

risk fx ectopic pregnancy

A

Previous ectopic pregnancy
Previous pelvic inflammatory disease
Previous surgery to the fallopian tubes
Intrauterine devices (coils)
Older age
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

presentation ectopic prg

A

6-8 weeks gestation
Missed period
Constant lower abdominal pain in the right or left iliac fossa
Vaginal bleeding
Lower abdominal or pelvic tenderness
Cervical motion tenderness (pain when moving the cervix during a bimanual examination)
dizziness
shoulder tip pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

first line ix ectopic preg

A

transvaginal USS-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ectopic preg what seen on imaging

A

gestational sac containing a yolk sac or fetal pole may be seen in a fallopian tube
or mass containing empty gestational sac - ‘blob sign’
tubal ectopic pregnancy moves separately to the ovary. The mass may look similar to a corpus luteum; however, a corpus luteum will move with the ovary
empty uterus
fluid in uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

definition pregnancy of unknown location

A

when the woman has a positive pregnancy test and there is no evidence of pregnancy on the ultrasound scan. In this scenario, an ectopic pregnancy cannot be excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how monitor pregnancy of unknown location

A

serum hCG -should double every 48 hours…not in miscarriage or ectopic preg
A rise of more than 63% after 48 hours is likely to indicate an intrauterine pregnancy - any less = ectopic preg or if <50 = miscarriage
>1500 - pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

mx of ectopic preg

A

preg test
referral to early pregnancy assessment unit or gynaecological service
termination - expectant (wait natural), medical (methotrexate), surgery (salpingectomy, salpingotomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

criteria for expectant mx

A

Follow up needs to be possible to ensure successful termination
The ectopic needs to be unruptured
Adnexal mass < 35mm
No visible heartbeat
No significant pain
HCG level < 1500 IU / l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

criteria for methotrexate termination

A

Follow up needs to be possible to ensure successful termination
The ectopic needs to be unruptured
Adnexal mass < 35mm
No visible heartbeat
No significant pain
confirmed basence of intrauterine preg on USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

advise following methotrexate mx

A

advised not to get pregnant for 3 months following tx
s/e - Vaginal bleeding
Nausea and vomiting
Abdominal pain
Stomatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pros and cons of surgical options of ectopic preg

A

laprascopic salpingectomy - 1st line
laparasopic salpingotomy - avoid removing affected fallopian tube if increased risk of infertility, increased risk of failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

given alongside surgical tx of ectopic preg

A

if rhesus neg = anti rhesus D prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

early miscarriage

A

<12 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

late miscarriage

A

12-24 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

missed miscarriage def

A

the fetus is no longer alive, but no symptoms have occurred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

threatened miscarriage def

A

vaginal bleeding with a closed cervix and a fetus that is alive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

inevitable miscarriage def

A

vaginal bleeding with an open cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

incomplete miscarriage def

A

retained products of conception remain in the uterus after the miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

complete miscarriage def

A

a full miscarriage has occurred, and there are no products of conception left in the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

anembryonic preg def

A

a gestational sac is present but contains no embryo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ix for miscarriage diagnosis

A

transvaginal USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how assess if miscarriage

A
  1. Mean gestational sac diameter (>25mm)
  2. Fetal pole and crown-rump length (>7mm)
  3. Fetal heartbeat (visible = viable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

mx of miscarriage

A

<6 weeks - expectant mx and repeat preg test 7-10 days after
>6 weeks - early pregnancy assessment service for USS for expectant mx, medical mx (misoprostol), surgical mx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
indications for expectant mx of miscarriage
first line for women without risk fx for heavy bleeding or infection
26
medical mx of miscarriage
a prostaglandin analogue, meaning it binds to prostaglandin receptors and activates them. Prostaglandins soften the cervix and stimulate uterine contractions s/e - heavy bleeding, pain, vomit, diarrhoea
27
surgical tx of miscarriage
Manual vacuum aspiration under local anaesthetic as an outpatient (<10 weeks and good for women who have previously given birth) Electric vacuum aspiration under general anaesthetic +antirhesus d prophylaxis is rhesus -ve after
28
options for incomplete miscarriage
Medical management (misoprostol) Surgical management (evacuation of retained products of conception)
29
complication of ERPC
endometritis (infection of the endometrium)
30
recurrent miscarriage definition
3 or more consecutive miscarriages
31
when ix recurrent miscarriages
Three or more first-trimester miscarriages One or more second-trimester miscarriages
32
causes of recurrent miscarriage
Idiopathic (particularly in older women) Antiphospholipid syndrome Hereditary thrombophilias Uterine abnormalities Genetic factors in parents (e.g. balanced translocations in parental chromosomes) Chronic histiocytic intervillositis Other chronic diseases such as diabetes, untreated thyroid disease and systemic lupus erythematosus (SLE)
33
antiphospholipid syndrome definition
a disorder associated with antiphospholipid antibodies, where blood becomes prone to clotting. The patient is in a hyper-coagulable state. The main associations are with thrombosis and complications in pregnancy, particularly recurrent miscarriage.
34
antiphospholipid syndrome primary or secondary
both can occur due to autoimmune such as SLE
35
how lower risk of miscarriage with antiphospholipid syndrome
LMWH low dose aspirin
36
inherited thrombophilias causing recurrent miscarriage
Factor V Leiden (most common) Factor II (prothrombin) gene mutation Protein S deficiency
37
uterine abnormalities causing recurrent miscarriage
Uterine septum (a partition through the uterus) Unicornuate uterus (single-horned uterus) Bicornuate uterus (heart-shaped uterus) Didelphic uterus (double uterus) Cervical insufficiency Fibroids
38
define chronic histiocytic intervillositis
a rare cause of recurrent miscarriage, particularly in the second trimester
39
CHI patho
Histiocytes and macrophages build up in the placenta, causing inflammati
40
CHI diagnosis
placental histology showing infiltrates of mononuclear cells in the intervillous spaces
41
ix for recurrent miscarriage
Antiphospholipid antibodies Testing for hereditary thrombophilias Pelvic ultrasound Genetic testing of the products of conception from the third or future miscarriages Genetic testing on parents
42
mx of recurrent miscarriage
depends on underlying cause ?vaginal progesterone pessaries during early pregnancy for women with recurrent miscarriages presenting with bleeding
43
legal number of weeks for abortion
24 weeks
44
abortion indications before 24 weeks
An abortion can be performed before 24 weeks if continuing the pregnancy involves greater risk to the physical or mental health of: The woman Existing children of the family
45
abortion indications any time during pregnancy
Continuing the pregnancy is likely to risk the life of the woman Terminating the pregnancy will prevent “grave permanent injury” to the physical or mental health of the woman There is “substantial risk” that the child would suffer physical or mental abnormalities making it seriously handicapped
46
legal requirements for abortion to be carried out - who there and where
Two registered medical practitioners must sign to agree abortion is indicated It must be carried out by a registered medical practitioner in an NHS hospital or approved premise
47
<10 weeks abortion
telephone consultations and medication
48
medical abortion
Mifepristone (anti-progestogen) Misoprostol (prostaglandin analogue) 1 – 2 day later
49
surgical abortion
Prior to surgical abortion, medications are used for cervical priming. This involves softening and dilating the cervix with misoprostol, mifepristone or osmotic dilators. options: Cervical dilatation and suction of the contents of the uterus (usually up to 14 weeks) Cervical dilatation and evacuation using forceps (between 14 and 24 weeks)
50
post abortion care
vaginal bleeding and abdo cramps up to 2 weeks after preg test 3 weeks after to confirm contraception counselling
51
complications of abortion
Bleeding Pain Infection Failure of the abortion (pregnancy continues) Damage to the cervix, uterus or other structures
52
when N+V peaks
8-12 weeks gestation
53
severe form of N+V
hyperemesis gravidarum
54
cause of N+V
hCG
55
worse N+V when
molar pregnancies multiple pregnancies first preg preg overweight or obese
56
hyperemesis gravidarum diagnosis
“protracted” NVP plus: More than 5 % weight loss compared with before pregnancy Dehydration Electrolyte imbalance
57
how N+V assessed
Pregnancy-Unique Quantification of Emesis (PUQE) >12 = severe <7 = mild
58
mx of N+V
Prochlorperazine (stemetil) Cyclizine Ondansetron Metoclopramide Ginger Acupressure on the wrist at the PC6 point (inner wrist) may improve symptoms
59
reflux tx
Ranitidine or omeprazole
60
when N+V require admission
Unable to tolerate oral antiemetics or keep down any fluids More than 5 % weight loss compared with pre-pregnancy Ketones are present in the urine on a urine dipstick (2 + ketones on the urine dipstick is significant) Other medical conditions need treating that required admission
61
moderate-severe cases of N+V tx
IV or IM antiemetics IV fluids (normal saline with added potassium chloride) Daily monitoring of U&Es while having IV therapy Thiamine supplementation to prevent deficiency (prevents Wernicke-Korsakoff syndrome) Thromboprophylaxis (TED stocking and low molecular weight heparin)
62
molar pregnancy definition
A hydatidiform mole is a type of tumour that grows like a pregnancy inside the uterus either complete or partial
63
complete mole why happens
when two sperm cells fertilise an ovum that contains no genetic material (an “empty ovum”). These sperm then combine genetic material, and the cells start to divide and grow into a tumour called a complete mole. No fetal material will form.
64
partial mole why happens
two sperm cells fertilise a normal ovum (containing genetic material) at the same time. The new cell now has three sets of chromosomes (it is a haploid cell). The cell divides and multiplies into a tumour called a partial mole. In a partial mole, some fetal material may form.
65
diagnosis molar pregnancy
More severe morning sickness Vaginal bleeding Increased enlargement of the uterus Abnormally high hCG Thyrotoxicosis (hCG can mimic TSH and stimulate the thyroid to produce excess T3 and T4)
66
molar pregnancy presentation
diagnostic fx but appears like normal preg = periods stop and hormonal changes will occur
67
Ix of molar preg
USS = snowstorm appearance histology of mole after evacuation
68
mx of molar preg
evacuation of uterus histology to confirm referred to gestational trophoblastic disease centre for f/u hCG level monitored
69
complication of molar preg
mole can metastasise...chemo
70

obs and gynae (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions