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Flashcards in Early pregnancy problems Deck (15):
1

Miscarriage

pregnancy failure before the completion of 24 weeks gestation

2

Early miscarriage

less than 12 weeks pregnancy

3

Late miscarriage

from 12 -24 weeks pregnancy

4

Recurrent miscarriage

3 or more consecutive losses before 24 weeks
• if one partner has a chromosomal abnormality

5

Causes of miscarriage

1. maternal age
2. Chromosomal abnormality
3. Congenital defect of uterus - there is a septum
4. Fibroids - intefere with implanatation
5. Antiphospholipid syndrome - autoimmune, predisposes to blood clots/Thrombophilia - thrombosis of uteroplacental circulation causes blood clot
6. Cervical weakness - dilates too early causing loss of foetus

6

Pathophys of ectopic pregnancy

• Implantation anywhere outside the uterine cavity mainly in the fallopian tube
• Fallopian tube should transports egg from ovary to uterus

7

symptoms of ectopic pregnancy

• Abnormal vaginal bleeding
• Abdominal pain - rebound tenderness
• Tachycardia - caused by bloodloss

8

Invest of ectopic pregnancy

• urine HCG
• ultrasound
• laproscopy

9

Risk factors of ectopic pregnancy

• Damage to fallopian tube - Pelvic inflammatory disease(caused by sti), surgery to fallopian tubes
• Endometriosis
• Smoking
• Previous ectopic pregnancy
• Fertility treatment - Invitro

10

Postpartum haemorrhage

1. Primary - more than 500 ml loss within 24 hours of delivery
2. Secondary - significant loss between 24 hours to 6 weeks

11

Causes of primary postpartum haemorrhage - TONE

1. Tone - atony
- Myometrium is the smooth muscle of uterus and will contract after delivery to clamp placental arteries to stop blood loss.
• Repeated distention of uterus from multiplepregnancies
•Muscle fatigue from long labour
MYOMETRIUM IS UNABLE TO CONTRACT AS STRONGLY AND IS UNABLE TO CLAMP THE PLACENTAL ARTERIES

12

Causes of primary postpartum haemorrhage - TRAUMA

- Vaginal tear
- incision from caesuras

13

Causes of primary postpartum haemorrhage - TISSUE

1.Placenta retention in the urterine cavity
2.prevents effective uterine contraction
3.Uterine atony

14

Causes of primary postpartum haemorrhage - THROMBIN

1. Deficiency of coagulation factors makes bleeding more likely / Von Willebrands etc

15

Causes of secondary postpartum haemorrhage

1. Endometritis - inflammation of lining of uterus
2. Persistent trophoblastic disease- molar pregnancies