Flashcards in Exam 3 Abn Preggo 1 Deck (20):
Ectopic Pregnancy is?
Implantation other than in endometrial cavity
Any that impairs tube's ability to transport gametes or embryos
Ectopic Pregnancy presentation? (3)
Pelvic/abd pain, bleeding
Hemoperitoneum sxs: shoulder pain, subdiaph pain
Orthostatic sxs: dizzy, syncope, weak from blood loss
Ectopic Pregnancy physical exam should include? (3)
Vitals for ortho ∆s, signs of shock
Pelvic: unilat mass, tender, cervical tender
Ectopic Pregnancy labs? (3)
CBC: for anemia
Quant hCG: ↑ >53% over 48hrs in N preggo, less in ectopic
Serum progest: 20 is N, ectopic is lower
Ectopic Pregnancy: Trans Vag US?
If "preg of unknown location", next step?
Visualize IUP or ectopic
IUP = Gestational sac as double ring at 5 wks, cardiac activity @ 5-6 wks
If can't confirm either = preg of unknown location
If unknown loc -> follow w/ serial QhCG and TVUS until confirmation
Ectopic Pregnancy tx? (4)
Methotrexate for fetal reabsorb
Ectopic Pregnancy: When use meds instead of surgery? (5)
< 3.5 cm
QhCG < 5k
Ruptured vs unrup
Reliable to f/u
Gestational Trophoblastic Dz (GTD) is?
Tumors from abnormal trophoblast cells ->
grow inside the uterus after conception
Hydatidiform mole is? (5)
Most C GTD
Chorionic villi become mass of clear "grapes"
Partial: Fetus U present (fertilized by 2 sperm), missed abortion
Complete: fetus absent (fertilization of empty egg), theca lutein cysts
Hydatidiform mole presentation? (6)
Snow storm on US
Preeclampsia before 20 wks
Hydatidiform mole tx? (3)
Evacuation of uterus
Monitor QhCG x 6-12 mo
Avoid preggo for 1 yr
Malignant tumor from any trophoblastic tissue (mole, ectopic, normal preg)
Choriocarcinoma presentation? (6)
U not sen until already mets
Irreg vag bleeding
Choriocarcinoma dx? (2)
High QhCG and snowstorm on US
CT abd, pelvis, head
Choriocarcinoma tx? (3)
Hyperemesis Gravidarum is?
Unexplained, intractable N/V in 1st tri
Causes dehyd, ketonuria, wgt loss
U resolves by 20 wks
Rh D Alloimmunization pathophys?
Rh - mom w/ Rh + fetus
Mom makes IgG Ab's against baby RBCs
Rh D Allo presentation?
None in mom
Affected baby = mild anemia/↑bilirubin -> ↓tone, poor feed, apnea, seizures death
Rh D Allo dx studies? (2)
Draw titers 26-28 wks
↑titers = sensitization
Doppler -> measure middle cerebral artery flow (high velocity = anemia)