Flashcards in Outcome 4 Conception and Early Pregnancy Deck (89):
Abnormal proliferation of placental tissue than can take on characteristics of malignancy
hydatidiform (hydatid) mole
Placenta has a ___ appearance on ultrasound or the diagnosis may come from evaluation after miscarriage/abortion
Hydatid mole is caused by ___ during fertilization where the placenta develops abnormally as a mass of clear grape like vessels
How are hydatid moles treated?
1. evacuation of the uterus by dilation
Pregnancy should be avoided for at least __ months after removal of a hydatid mole
Fertilized egg implants that grows outside of the endometrial canal, most often the fallopian tube
What medication is prescribed for early unruptured ectopic pregnancies?
Methotrexate causes the ___ to die and the products to be reabsorbed by the body
What surgeries treat ectopic pregnancy?
1. laparoscopic surgery
2. tubal conservation if unruptured
Severe state of morning sickness that doesn't respond to over the counter remedies, requires prescription medicine or hospitalization
Hyperemesis gravidarum is ssociated with weight loss of more than __ and metabolic disturbances and dehydration
Hyperemesis gravidum is linked to elevated ___ and ___
estrogen and hCG
Which patients have a higher risk for hyperemesis gravidum?
patients with underlying emotional disturbances with abusive relationships
What is ruled out with hyperemesis gravidum
How is hyperemesis gravidum treated?
1. patient hospitalized
2. electrolyte imbalance corrected with salts
Refer to number of times the patient has been pregnant
Refer to number of past pregnancies that have gone to viability and have been delivered
Number of times the female delivered a baby
Woman who is not pregnant and has never been pregnant
Woman who has never delivered a child
Female who has delivered a fetus that reached viability
Female that has been pregnant 2 or more times
Female that has delivered more than one baby
Female who have just given birth up to 42 days following delivery
Naturally occurring loss of a fetus before the 20th week of pregnancy. Also called “missed” or “incomplete”
spontaneous abortion or miscarriage
__% of all pregnancies end in spontaneous abortions.
Spontaneous abortion results from ____.
What 4 factors are associated with increased risk of abortion?
2. metabolic disturbances
3. maternal antibody production
4. lupus or clotting disorders
Spontaneous abortion with no severe bleeding is treated how?
Allowing the products of conception to pass on their own; given medication to expedite the passage of fetal and placental tissue
Spontaneous abortion with severe bleeding is treated how?
Dilation, other surgical interventions
What is checked in spontaneous abortion?
Rh factor of mother
Non-invasive test in pregnancy providing detailed information on the health of the fetus
18 week ultrasound
What 4 thingscan be detected at 18 week ultrasound?
1. heart abnormalities
2. developmental problems of genitoruinary system which are incompatible with life
3. nervous system disorders
18-week ultrasound is completed at what gestational age?
Needle sample of chorion guided by ultrasound
chorionic villus sampling (CVS)
What can be detected during a chorionic villus sampling?
early detection of abnormalities to ensure time to decide whether or not to proceed with the pregnancy
CVS is completed at what gestational age?
Maternal blood sample
Maternal Serum Screen (MSS)
What does the maternal serum screen measure?
2. maternal alphaprotein
3. unconjugated estrogen
What is detected during MSS?
estimates risk of
1. spina bifida
2. trisomy 21 or down syndrome
3. trisomy 18 or edwards syndrome
4. open neural tube defects
MSS relies on accurate _____
MSS is is completed at what gestational age?
Nuchal translucency screen (ultrasound measurement)
First Trimester Screen (FTS)
BhCG, pregnancy associated with ___, risk of ___ can be detected in FTS
plasma protein A, down syndrome
FTS is not useful in ____
False positives in FTS should follow ___ or ___ to confirm
FTS is completed at what gestational age?
Combines use of FTS and MSS
integrated prenatal screen
Integrated prenatal screen detects Down Syndrome in __% of pregnancies but should still be followed by _____ to confirm
Integrated prenatal screen is completed at what gestational age?
1st: 11-14 weeks
2nd: 15-20 weeks
Assessment of genetic karyotype allowing for accurate prenatal diagnosis of genetic abnormalities including down syndrome
Which is more accurate: amniocentesis or CVS?
Amniocentesis can reveal the maturity of the ___ and ___ defects
fetal lung, open neural tube defects
AMniocentesis provides information on ______ affected pregnancies
Amniocentesis is completed at what gestational age?
Amniocentesis takes ___ days for results
What days are the menstrual cycle?
During the menstrual cycle, __ and __ are rising
FSH and LH
Proliferative phase days
5-14 but varies between women
Secretory phase days
Secretory phase is always __ days in length
How many trimesters in a pregnancy?
How long is the first trimester?
How long is the second trimester?
How long is the third trimester?
What are the 2 phases of pregnancy?
Pregnancy phase spanning the first two months
Pregnancy phase spanning the third through ninth months?
Hydatidiform is also called a ___
T or F. Molar pregnancies can become cancerous.
What are 5 risk factors for ectopic pregnancies?
2. pelvic adhesions due to previous pelvic infection or surgery
3. damaged fallopian tubes
4. progesterone contraception
5. previous tubal ligation
What are the 3 categories for risk factors?
1. past obstetrical history
2. medical history
3. problems in current pregnancy
What ages are risk factors in pregnancy?
What are the risks for having a baby past 35 years old?
How many kg overweight must a woman be to be considered a risk factor in pregnancy
What are problems in current pregnancy that are risk factors?
1. membrane rupture before 37 weeks
3. gestational diabetes
4. post term pregnancy (>42 weeks)
5. absence of fetal movements
6. exposure to smoking and drugs
When is absence of fetal movements worrisome?
1. more than 24 hours after the 20th week
2. fewer than 10 movements per hour after the 28th week
abortions (all types: elective or miscarriage)
What are the 3 classifications of spontaneous abortions?
What is a missed spontaneous abortion?
no tissue has passed
What is an incomplete spontaneous abortion
some tissue has passed
What is a complete spontaneous abortion?
all tissue has passed
In 18-week ultrasound, a ___ is done and provides a score out of 2 for a possible total of 10
biophysical profile (BPP)
What 5 things can a BPP indicate?
1. amniotic fluid volume
2. breathing movements
3. limb (body) movements
4. fetal tone (muscle)
5. heart rate/non-stress test
What is the difference between CVS and amniocentesis?
CVS can't detect neural tube defects, is less accurate
What is the main advantage of CVS over other screening tests?
more specificity, sensitivity