Gynae teaching 1 Flashcards
What is a pregnancy of unknown location?
When there is a positive pregnancy test but nothing is seen on an ultrasound
What is the aetiology of a pregnancy of unknown location?
- It’s too early: a positive test will be seen with HCG 300 IU/L, but a pregnancy may not be seen on ultrasound scan until the level is around 1500 IU/L
- Miscarriage: the pregnancy was there but not anymore
- Small ectopic pregnancy
How is a pregnancy of unknown location managed?
- Do blood HCG
- Safety net
- If HCG is increasing, repeat ultrasound
- If HCG is decreasing, do a follow up negative pregnancy test
What is mennorhagia?
Heavy menstrual bleeding
What are some causes of menorrhagia?
- Dysfunctional Uterine Bleeding (DUB)
- Fibroids
- Adenomyosis
- Copper IUCD
- Bleeding disorders
- Thyroid Disorders
What is Dysfunctional Uterine Bleeding (DUB)?
Abnormal uterine bleeding resulting from an ovarian endocrinopathy
How is dysfunctional uterine bleeding treated?
- Contraception to control the bleeding: pill, injections, implant, mirena coil
- Surgery: endometrial ablation, hysteroscopy
What are some causes of inter-menstrual bleeding?
- Anovulation (absence of ovulation)
- Endometrial polyps
- Progesterone only contraceptives
- Endometrial cancer
What are some causes of post coital bleeding?
Cervical polyps
Ectropion
Infection (Chlamydia)
Cervical cancer
What is Adenomyosis?
When endometrial tissue in the lining of the uterus to grows into the muscular wall of the uterus, enlarging it and causing very heavy menstrual bleeding
What is the difference between primary and secondary amenorrhoea?
Primary: no period after age 16 in the presence of normal secondary sexual characteristics, or 14 years in the absence of other evidence of puberty
Secondary: absent periods for at least six months in a woman who has previously had regular periods, or 12 months if she has previously had oligomenorrhoea (bleeds less frequently than six-weekly)
What are the causes of amenorrhoea?
- Hypothalamic
- Pituitary
- Ovarian
- Anatomical: Mullerian abnormalities
What are Mullerian abnormalities?
Congenital disorders of sexual anatomy
Give examples of mullerian anomalies
Transverse septum: a horizontal wall of tissue in the vagina causing a blockage
Imperforate hymen: a membrane extends all the way across the area of the hymen, blocking the vaginal opening
Rokitansky syndrome: underdeveloped vagina and uterus (uterus is small/absent and vagina is short)
What is Asherman’s syndrome?
When adhesions and scarring occurs inside the uterus
Caused by several dilatation and curettage (curette: spoon-shaped instrument used to remove abnormal tissue) procedures for diagnosis of uterine conditions
Or caused by infections like TB
