Pain and Vomiting in Early Pregnancy Flashcards Preview

Reproductive - Reproductive Gynaecology > Pain and Vomiting in Early Pregnancy > Flashcards

Flashcards in Pain and Vomiting in Early Pregnancy Deck (28):
1

The pain felt during a miscarriage varies in intensity and frequency depending on what?

How far through the miscarriage is

2

What is a more predominant symptom than pain in a miscarriage?

Bleeding

3

What is the predominant symptom of an ectopic pregnancy?

Pain

4

Describe the pain felt in an ectopic pregnancy?

Starts as a dull ache and develops into a sharp stabbing pain

5

Ectopic pregnancy can lead to peritonism, what are some signs of this?

Rigidity and rebound tenderness

6

What are some pregnancy unrelated causes of pain in early pregnancy?

UTI, appendicitis, vaginal infections, PID

7

What are the treatment options for rhesus negative women who have a miscarriage or ectopic pregnancy?

Conservative/medical/surgical

8

What is the management option for rhesus negative women who have a molar pregnancy?

Surgery

9

Any rhesus negative women who is managed for a miscarriage/ectopic/molar pregnancy with surgery should be given what? What is the purpose of this?

500IU of anti-D / to prevent antibodies being formed which may affect a future pregnancy

10

How is hyperemesis gravidarum clinically diagnosed?

Persistent vomiting and weight loss > 5% of pre-pregnancy body weight

11

When do symptoms of normal, pregnancy induced N+V usually a) start b) peak c) resolve?

a) 6-8 weeks b) 9-11 weeks c) 16 weeks

12

What is responsible for causing nausea and vomiting in pregnancy?

beta hCG

13

What can hyperemesis gravidarum result in?

Dehydration, malnutrition, electrolyte disturbances, ketosis, weight loss and altered liver function

14

What are some deficiencies that hyperemesis gravidarum result in?

Hyponatraemia and thiamine deficiency

15

What can thiamine deficiency result in?

Wernicke's encephalopathy

16

Hyperemesis gravidarum is a diagnosis of exclusion. What are some things you must exclude?

UTI, gastritis, peptic ulcers, viral hepatitis, pancreatitis

17

What are 3 investigations used for hyperemesis gravidarum?

Urinalysis, blood tests, US

18

What is a urinalysis used for in hyperemesis gravidarum?

If there are ketones, the patient must be admitted and also to exclude a UTI

19

What is an US used for in hyperemesis gravidarum?

To exclude multiple and molar pregnancies which can cause increased vomiting

20

Hyperemesis gravidarum is most common when?

In a first pregnancy, and in women who experience N+V in relation to the COCP, motion and migraines

21

What are some principles of management of hyperemesis gravidarum?

IV fluids, nutritional support, parenteral anti-emetics, vitamine supplementation

22

What can be used in recurrent, severe cases of hyperemesis gravidarum?

Steroids

23

What is given to patients with hyperemesis gravidarum who have decreased mobility and extreme dehydration?

Thomboprophylaxis

24

What are some first line anti-emetics for hyperemesis gravidarum?

Cyclizine and prochlorperazine

25

What are some second line anti-emetics for hyperemesis gravidarum?

Ondansetron and metoclopramide

26

Why is early resolution of hyperemesis gravidarum especially important in those with chronic conditions?

To keep their medications working

27

How long does hyperemesis gravidarum usually last for?

Mainly just the 1st trimester

28

What is the ultimate treatment in extremely severe cases of hyperemesis gravidarum?

Termination of pregnancy