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Early Pregnancy Complications Flashcards

1
Q

When does 1st trimester end

A

week 13

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2
Q

When does 2nd Trimester end

A

Week 28

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3
Q

What marker is used to confirm pregnancy

A

BhCG

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4
Q

What % of women have early pregnancy bleeding?

A

20%

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5
Q

List 3 abnormal pregnancy outcomes:

A

Ectopic pregnancy
Miscarriage
Molar Pregnancy

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6
Q

List 3 symptoms of miscarriage:

A

Positive Urine Pregnancy test
Bleeding (abnormal)
Strong cramping

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7
Q

What examination can be done to confirm miscarriage?

A

Speculum exam

- Looking to see if OS is open or closed

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8
Q

What investigation can be done in suspected miscarriage?

A

Ultrasound

Confirm empty uterus or not

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9
Q

List the symptoms of cervical shock:

A 
Cramps
nausea
Vomiting
Sweating
Fainting
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10
Q

What causes cervical shock?

A

When products from pregnancy are not completely expelled.

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11
Q

Give 4 infections can cause miscarriage?

A

CMV
Rubella
Toxoplasmosis
Listeria

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12
Q

Give 4 other causes of miscarriage:

A

Immunological Problems
Genetic problems
Emotional Upset/stress
Environment / trauma

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13
Q

Define threatened miscarriage:

A

When there is a risk to pregnancy but pregnancy has not yet terminated

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14
Q

Define inevitable miscarriage:

A

There is no way to save the pregnancy

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15
Q

What is early foetal demise?

A

When the pregnancy is still in-situ but there is no heartbeat

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16
Q

What term is used to describe an empty sac with no foetus?

A

Anembryonic Pregnancy

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17
Q

How many miscarriages must occur to be defined as “recurrent miscarriage” worth investigating

A

3 or more

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18
Q

What immunological condition carries a high risk of miscarriage?

A

Anti-phosholipid syndrome

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19
Q

What term is used when a fertilized egg implants outwith the uterus

A

Ectopic pregnancy

20
Q

Give the most common implantation site in ectopic pregnancy

A

Ampulla of the Fallopian tube

21
Q

List 3 other places of implantation in ectopic pregnancy

A

C-section scar
Peritoneum
Ovary

22
Q

List some symptoms of ectopic pregnancy

A 
Severe pain
Bleeding  
Dizziness
Collapse
SOB
(shoulder tip pain)
23
Q

List some clinical signs you might see when a patient presents with an ectopic pregnanacy

A 
Pallor
Signs of peritonism
Abdominal guarding and tenderness
Sweating
Haemodynamic instability i.e.  vital signs of intraperitoneal bleeding
24
Q

Give 3 investigations which can be done for suspected ectopic pregnancy:

A

Full blood count
Serum hCG (looking for doubling)
USS

25
Q

When is surgical management appropriate for ectopic pregnancy?

A

When the mother is acutely unwell - risk to life

26
Q

What is a molar pregnancy?

A

A gestational trophoblastic disease where there is overgrowth of placental tissue

27
Q

What is a complete mole?

A

When there’s an egg without DNA and no fetus

28
Q

What is a partial mole?

A

When there is a haploid cell which may have a fetus

29
Q

What sign can be seen on USS of molar pregnancy

A

Snow storm appearance

30
Q

What important signs/symptoms should you look out for in a molar pregnancy?

A 
Hyperemesis
Grape like tissue with varied bleeding
SOB
An unusually large uterus for GA
Pelvic pain
Vital signs of bleeding/shock
31
Q

When does implantation bleeding usually occur?

A

10 days post implantation

32
Q

What is Chorionic Haematoma

A

Pooling of blood between the endometrium and the embryo due to sac separation

33
Q

Chorionic Haematoma’s usually resolve - true/false?

A

True

Larger ones may cause infection and miscarriage

34
Q

Define hyperemesis gravidarum:

A

Vomiting during pregnancy in excess which is altering the quality of life

35
Q

What side effects can occur from hyperemesis gravidarum

A 
Dehydration
Ketosis
Electrolyte imbalance
Weight loss
Malnutrition
Emotional instability
36
Q

Two examples of first line anti-emetics for HG

A

Cyclizine

Prochlorperazine

37
Q

Two examples of 2nd line anti-emetics for HG

A

Ondansetron

Metoclopramide

38
Q

Give some risk factors for ectopic pregnancy:

A

Progesterone releasing IUDS
Tubal sterilisation surgery
previous ectopic

39
Q

Define miscarriage:

A

Th involuntary, spontaneous loss of pregnancy before 22 weeks, associated with unprovoked vaginal bleeding
May or may not have suprapubic pain

40
Q

A molar pregnancy has malignant potential. True or false?

A

True

Molar pregnancies can become gestational trophoblastic neoplasms

41
Q

What is a significant risk factor for molar pregnancies?

A

Age

<20 or >35 carries an increased risk

42
Q

What % of molar pregnancies becoming malignant?

A

20%

43
Q

What is the cure rate of post-molar gestational trophoblastic neoplasia?

A

95%

With fertility preserved

44
Q

What are the preferred managements of a molar pregnancy?

A

Suction Dilation and Evacuation
or
Hysterectomy (depending on children, age etc)

45
Q

What forms of management of a molar pregnancy, have a higher risk of malignancy?

A

Hysterectomy

Medical induction TOP

Reproduction (19 decks)

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