First trimester complications Flashcards
(55 cards)
when should the gestation sac be present
1800 mIU/ml TA
1000 mIU/mL TV
gestational sac diameter
l+ W+ H /3 = #
CRL
Most accurate (+/- .5 wks) (3 days)
used b/t 6- 12 wks
longest length excluding legswhat does crown-rump length plus 6 equal
gestational weeks
normal Gestational Sac
A normal GS grows 1.1mm/day from 5 to 8 weeks
what is the GS meaurement
Reliable indicator of gestational age prior to identification of CRL
when is the GS used to determine GA
Used to determine GA up to 6 weeks then MSD is primarily used to correlate GS size to CRL
Crown rump length
Embryo grows at a rate of 1 mm/day in the 1st trimester
Curled position
GA from 5.5 weeks +
Measurement from the top of head to the lower edge of torso
reflects embryonic growth
Highly accurate - Error of +/- 3 to 5 days
CRL used until 12 to 13 weeks
when should embryo be seen
TA = 25mm MSD EV = 16mm MSD
what percent of clinically recognized pregnancies are spontaneously miscarried
15%`
; loss rate may be even higher for early, clinically unrecognized pregnancies.
most common presentation for complications
Most common presentation for complications is vaginal spotting or frank bleeding, occurring in nearly 25% of patients during early stage of pregnancy.
implantation bleed
Appears post implantation (21days LMP)
Visible at 6-10 weeks
Sonographically may appear as a sonolucent space outside the gestational sac
Patient may be asymptomatic or present with painless spotting
subchorionic hemorrhage
Most common occurrence of bleeding in first trimester is from subchorionic hemorrhage.
Low-pressure bleeds result from process of implantation of fertilized ovum into endometrial cavity and myometrial wall.
Hemorrhage found between myometrium and margins of gestational sac; may or may not be associated with placenta
clinical findings of subchorionic hemorrhage
bleeding, spotting or uterine cramping; if hemorrhage becomes large enough, can lead to spontaneous abortion
findings can distinguish subchorionic hemorrhage from what
abruption placentae
subchorionic hemorrhage appearance
Crescent-shaped sonolucent fluid collection between the gestational sac and the uterine wall
if subchorionic hemorrhage is symptomatic (bleeding) increased chance of
miscarriage,
preeclampsia,
placental abnormalities,
preterm delivery
Size date discrepancy
Unsure LMP (incorrect dates) Presence of Fibroids Scarring Obesity Multiple gestation Molar pregnancy Pregnancy failure
diagnosis of a true GS may be made only in the presence of
yolk sac or embryo
without findings of intrauterine pregnancy, an intrauterine fluid collection could represent
pseudogestational sac associated with ectopic pregnancy
embryonic heart rates
5 - 6 weeks - 100 BPM
6+ weeks - 120 to 160 BPM
findings diagnostic of pregnancy failure
CRL of >7mm and no heartbeat
Mean sac diameter of >25mm and no embryo
Absence of embryo with heartbeat of >2wk after a scan that showed gestational sac without a yolk sac
``
Absence of embryo with heartbeat >11 days after a scan that showed a gestational sac with a yolk sac
Abortion
Spontaneous or induced termination of an early pregnancy and expulsion of fetal and placental tissues.
Anembryonic pregnancy (Blighted ovum)
Pregnancy that has failed prior to the development of an identifiable embryo or in which embryonic tissue has been resorbed after early embryo demise
