EARLY Pregnancy Problems Flashcards Preview

Jason's MD3 Women's > EARLY Pregnancy Problems > Flashcards

Flashcards in EARLY Pregnancy Problems Deck (33):
1

Any things prior to 12 weeks is?

Gynecology

2

What to ask woman who presents to ED with some bleeding from vagina

Possible you're preg?
Any N/&V and go away?
Amenorrhoea

3

Important about bHCG?

The quantitative amount: should double every 48 hours until week 8.

4

U/s and early preg?

U/S and bHCG is most useful
-If bHCG hits 1500-3500, will see a gestational sac and yolk sac
-bHCG 20 000 should see 5-10mm embryo at 7 weeks.

5

When can you see something u/S in early preg?

BHCG needs to be at least 1500 or you may not see anything especially if

6

Hyperemesis Gravidarum, likely in who?

Multiple pregs

7

Hyperemesis Gravidarum is?

Weight loss exceeding 5%, dehydration, keto urea

-onset 4-10 weeks

8

Test for Hyperemesis Gravidarum?

U/S to exclude multiple

9

Management of Hyperemesis Gravidarum?

Remove mole if it's mole

Ginger/acupressure
Diet
Avoid triggers
Psych

10

Hyperemesis Gravidarum, pharma?

B6
Maxalon
Phenergan: sedating
Ondansetron (constipation G)
Admission

11

What is EPAS?

Early pregnancy asessment service

12

Threatened miscarriage is?

Have some bleeding but a viable fetal heart then only 1-2% miscarriage

13

Complete miscarraige?

All products gone

14

Incomplete miscarriage?

Some products of conception remains

15

Septic miscarraige

Dangerous, rare,
Can die.
Used to be When termination was illegal.

16

Causes of miscarriage?

85% chromosomal abnormalities

17

Maternal causes of miscarriage

Advanced age
Diabetes
Thyroid
Phospholipid, lupus
Lifestyle

TRAUMA (domestic violence)

18

What causes miscarraige at 12-20 weeks (midterm)

Uterine septum
big Fibroid
Cervical incompetence

19

Bleeding in preg women?

Most are fit ned will compensate until the end.

20

Why do you get bradycardia and hypotension in miscarriage?

Cervical os is innervated by vagus

21

Dx of miscarriage?

CRL >7mm with no heart beat
Empty Gestational sac without yolk sac or fetal pole

22

What is a blighted ovum? When find out?

Empty gestational sac
See at 12 weeks.

23

Mx of miscarraige?

Expectant: wait and see (70%)
Medical - misoprostol (80%)
Surgical (D&C)uterine perforation
-ABx needed to prevent ascending infection
-No difference in satisfaction if mother chooses

24

D&C for miscarriage is actually?

dilation and Suction curettage

25

When is recurrent miscarriage?

3 consecutive miscarriages before investigations

26

Pregnancy of unknown location is?

Dont' know where it is.
Positive preg test, can't see on U/S with bHCG doubling

27

When need scan For PUL?

If stable: after 3 BHCG Abnormal= scan

If they're not well, then act now

28

Commonest reason for ectopic preg is?

Being preg!
93% ampullae

29

Which ectopic pregnancy is worse for bleeding?

Isthmus 4%

30

Ovary blood supply?

Ovarian artery directly from Aorta

31

clinical Presentation of ectopic pregnancy?

Acute: low Abdo pain (90%) peritoneal irritation

Vaginal bleeding (50%) shedding decidua

-adenexa L tenderness
Acute abdomen
Shoulder tip pain
Fainting

32

Recurrence of ectopic pregnancy?

10-15%

33

Methotrexate for ectopic pregnancy?

bHCG