Early Pregnancy Complications Flashcards
(35 cards)
What is an ectopic pregnancy?
Pregnancy that implants outside the uterus
Where are the most common locations for an ectopic pregnancy to implant?
The ampulla of the fallopian tube
What are common risk factors for Ectopic pregnancy?
PID
Levonorgestrel IUD
IVF pregnancy
Hx of ectopic pregnancies
What are common symptoms of an Ectopic pregnancy?
U/L lower abdominal or pelvic pain
vaginal bleeding
if ruptured: hypotensive with peritoneal irritation
What diagnostic test are used for an ectopic pregnancy?
b-hCG to confirm pregnancy
US to locate the site of implantation
How do you treat unstable patients with ectopic pregnancies?
fluids and immediate surgery
What baseline exams should you start with for ectopic pregnancy?
CBC: for anemia
Blood type/screen
Transaminases
How do you start to medically manage an ectopic pregnancy?
Consider giving Methotrexate: folate receptor antagonist
Follow b-hCG: is there a 15% decrease between days 4 and 7
-if not a second dose of methotrexate can be given
-if no decrease after 2nd dose proceed to surgery
What are the exclusion criteria for methotrexate use in an ectopic pregnancy?
Immunodeficiency
Noncompliance
Liver disease
Ectopic >3.5cm
Fetal Heartbeat
Breastfeeding
Coexisting viable pregnancy
What are common surgical options for an ectopic pregnancy?
Salpingostomy
Salpingectomy
What is the definition of an abortion?
Pregnancy that ends <20 weeks or a fetus <500grams
What are maternal factors that increase the risk of abortion?
Anatomic abnormalities
Infections: STDs
Immunological factors: Antiphospholipid sydnrome
Endocrine factors: uncontrolled HTN or DM
Malnutrition
Trauma
Rh isoimmunization
What are common symptoms of abortion?
Cramping abdominal pain
vaginal bleeding
What tests are used in diagnosing an abortion?
CBC
Blood type and Rh screen
US
Digital exam
What is a complete abortion?
No products of conception
Cervical os is closed
What is the next step for a complete abortion?
Follow up in office
What is an Incomplete abortion?
Some products of conception
Dilation of Cervix
What is the next step for an incomplete abortion?
D&C/medical
What is an inevitable abortion?
Products of conception are intact but there is intauterine bleeding
Dilation of cervix
What is the next step for an inevitable abortion?
D&C/medical
What is a threatened abortion?
Products of conception are intact with vaginal bleeding
NO dilation of cervix
What is the next step for a threatened abortion?
Pelvic rest
What is a missed abortion?
Death of fetus but all products of conception are in the uterus
Closed cervical OS
What is the next step for a missed abortion?
D&C/medical
