Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

reproductive system > pregnancy complications > Flashcards

pregnancy complications Flashcards

(64 cards)

Start Studying
1
Q

what is miscarriage

A

spontaneous loss of pregnancy before 24 weeks gestation (15%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list the types of miscarriage

A

threatened

inevitable

incomplete

complete

septic

missed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe the types of miscarriage

A

threatened: viable pregnancy, vaginal bleeding +/- pain, closed cervix
inevitable: viable pregnancy, heavy bleeding +/- clots, open cervix
incomplete: most of pregnancy is expelled out, (heavy) bleeding, open cervix
complete: passed out all products of conception, bleeding stopped, closed cervix

septic:

missed: asymptomatic, brown discharge, no clear foetus (empty gestational sac) or foetal pole with no ♡

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the aetiology of spontaneous miscarriage

A

maternal: uterine abnormality (fibroids), cervical weakness, increasing age, diabetes
conceptus: chromosomal, genetic or structural abnormality

unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the management of miscarriages?

A

expectant management:

medical management: misoprostol

surgical management:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is an ectopic pregnancy?

A

pregnancy implanted outside the uterine cavity (~1%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

give examples of sites of miscarriage?

A
  • ampulla of fallopian tube (most common)
  • isthmus of fallopian tube
  • interstium of fallopian tube
  • ovary (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the risk factors for ectopic pregnancy?

A
  • pelvic inflammatory disease
  • previous tubal surgery
  • previous ectopic surgery
  • assisted conception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do ectopic pregnancies present?

A
  • vaginal bleeding
  • pain abdomen
  • GI or urinary symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how are ectopic pregnancies investigated?

A

scan

  • no intrauterine gestational sac
  • may see adnexal mass
  • fluid in Pouch of Douglas

serum BHCG

  • track levels over 48 hour intervals
  • if normal early intrauterine pregnancy, HCG levels will increase by at least 66%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how are ectopic pregnancies managed?

A
  • conservative
  • medical: methotrexate
  • surgical: laproscopy - salpingectomy or salpingotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is an antepartum haemorrhage?

A

haemorrhage from the genital tract after the 24th week of pregnancy but before delivery of the baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the causes of antepartum haemorrhage?

A
  • placenta praevia
  • placental abruption
  • unknown origin
  • local lesions of the genital tract
  • vasa praevia (very rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is placenta praevia

A

placenta implants in lower uterine segment

common in: multiparous women, multiple pregnancies, previous C section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the presentation of placenta praevia

A
  • painless bleeding
  • malpresentation of foetus
  • soft, non tender uterus

diagnosis: ultrasound scan (incidental)
management: c section, watch for PPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the classifications of placenta praevia?

A

Grade I: Placenta encroaching on the lower segment but not the internal cervical os

Grade II: Placenta reaches the internal os

Grade III: Placenta eccentrically covers the os

Grade IV: Central placenta praevia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the management of PPH ?

A

medical

  • oxytocin
  • ergometrine
  • carboprost
  • tranexemic acid

surgica

  • balloon tamponade
  • b lynch cutre
  • ligation of the uterine and iliac vessels
  • hyserterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is placental abruption?

A

haemorrhage resulting from premature separation of the placenta before the birth of the baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the risk factors for placental abruption?

A
  • pre-eclampsia/ chronic hypertension
  • polyhydramnios
  • smoking, increasing age, parity, cocaine use
  • previous abruption
  • multiple pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the presentation of placental abruption?

A
  • painful bleeding (may be minimal)
  • increased uterine activity

abruption can be:

  • revealed (can see blood)
  • concealed (bleeding inside so can’t see)
  • mixed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the management of APH depend on?

A

either:

  • expectant treatment
  • vaginal delivery
  • immediate Caesarean section

depends on:

  • amount of bleeding
  • general condition of mother and baby
  • gestation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are possible complications of placental abruption?

A
  • maternal shock, collapse
  • foetal distress & death
  • maternal DIC, renal failure
  • postpartum haemorrhage ‘couvelaire uterus’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is preterm labour?

A

onset of labour before 37 completed weeks of gestation (259 days)

  • 32-36 wks mildly preterm
  • 28-32 wks very preterm
  • 24-28 wks extremely preterm

spontaneous or induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some predisposing factors for preterm labour?

A
  • multiple pregnancy
  • polyhydramnios
  • APH
  • pre-eclampsia
  • infection eg UTI
  • prelabour premature rupture of membranes
  • idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how is preterm labour diagnosed?
- contractions with evidence of cervical change - test: foetal fibronectin consider possible cause: abruption, infection
26
what is the management of preterm deliveries
< 24 - 26 weeks: poor prognosis - tocolysis: to allow steroids/ transfer - steroids (unless contraindicated) - transfer to unit with NICU facilities - aim for vaginal delivery
27
What neonatal morbidity may result from prematurity?
- respiratory distress syndrome - intraventricular haemorrhage - cerebral palsy - nutrition - temperature control - jaundice - infections - visual impairment - hearing loss
28
examples of hypertensive disorders in pregnancy
- chronic hypertension - gestational hypertension - pre-eclampsia
29
what is considered significant proteinuria?
automated reagent strip urine protein: > 1+ spot urinary protein: creatinine Ratio > 30 mg/mmol 24 hours urine protein collection > 300mg/ day
30
who is chronic hypertension commoner in?
older mothers
31
How should chronic hypertension in pregnancy be managed?
keep BP < 150/100 monitor for superimposed pre-eclampsia and foetal growth may have a higher incidence of placental abruption
32
examples of safe antihypertensives to use in pregnancy.
- labetolol - methyldopa - nifedipine
33
describe pre-eclampsia
- mild HT on two occasions more than 4 hours apart - moderate to severe HT PLUS proteinuria of more than 300 mgms/ 24 hours
34
describe pathophysiology of pre-eclampsia?
immunological genetic - secondary invasion of maternal spiral arterioles by trophoblasts impaired -> reduced placental perfusion - imbalance between vasodilators and vasoconstrictors in pregnancy (prostacyclin/thromboxane)
35
risk factors for PET?
- first pregnancy - extremes of maternal age - previous PET - pregnancy interval >10 years - BMI >35 - FMH - multiple pregnancy - underlying medical conditions (HT, renal disease, DM, autoimmune disorders)
36
What are the possible complications of PET?
maternal - eclampsia (seizures) - severe HT (stroke) - HELLP (haemolysis, elevated liver enzymes, low platelets) - DIC - renal failure - pulmonary oedema and cardiac failure foetal - IUGR - foetal distress - prematurity
37
What are the signs and symptoms of severe PET?
- headache - blurry vision - epigastric pain, pain below ribs - vomiting - swelling of hands face legs - severe hypertension; > 3+ of urine proteinuria - clonus/brisk reflexes; papillodema, epigastric tenderness - reducing urine output - convulsions (Eclampsia)
38
What biochemical abnormalities can occur in severe PET?
- raised liver enzymes, bilirubin if HELLP present | - raised urea an creatinine, raised urate
39
What haematological abnormalities can occur in severe PET?
- low platelets - low haemoglobin, signs of haemolysis - features of DIC
40
What is the management for PET?
frequent checks: BP and urine protein symptoms checks: headaches, epigastric pain, visual disturbances, hyperreflexia and tenderness over liver bloods: FBC, LFTs, U+Es, coagulation foetal investigations: scans and CTG
41
What is the only cure for PET?
Delivery of the baby and placenta
42
What is the conservative approach for PET?
- observation - anti-hypertensives (labetolol, methyldopa, nifedipine) - steroids for fetal lung maturity if gestation < 36wks
43
What is the epidemiology of PET and eclampsia?
- 5-8% of pregnant women have PET - 0.5% women have severe PET & 0.05% have eclamptic seizures - 38% of seizures occur antepartum, 18% intrapartum, 44% postpartum
44
How are eclamptic seizures and impending seizures treated?
magnesium sulphate bolus + IV infusion blood pressure control - IV labetolol, hydrallazine (if > 160/110) avoid fluid overload - aim for 80mls/hour fluid intake
45
What is the prophylaxis for PET in further pregnancies?
- low dose aspirin from 12 weeks to delivery | increased risk to develop hypertension in later life
46
What is gestational diabetes?
carbohydrate intolerance with onset in pregnancy abnormal glucose tolerance that reverts to normal after delivery (however, more at risk of developing type II diabetes later in life)
47
What effect does pre-existing diabetes have on pregnancy?
- insulin requirements of the mother increase | - foetal hyper-insulinaemia occurs
48
why do insulin requirements increase in pregnancy?
- human placental lactogen - progesterone - human chorionic gonadotrophin - cortisol from placenta have anti-insulin action
49
why does foetal hyper-insulinaemia occur?
maternal glucose crosses the placenta and induces increased insulin production in the foetus. foetal hyperinsulinemia causes macrosomia
50
what are neonates of diabetic mothers at increased risk of?
- neonatal hypoglycaemia | - respiratory distress
51
what does diabetes in pregnancy increase the risks of
maternal - pre-eclampsia - miscarriage - nephropathy, retinopathy, hypoglycaemia, reduced awareness of hypoglycaemia - infections foetal - congenital abnormalities (cardiac abnormalities, sacral agenesis) - macrosomia, polyhydramnios - shoulder dystocia, operative delivery - stillbirth, perinatal mortality neonatal - impaired lung maturity - neonatal hypoglycaemia - jaundice
52
what is the management for diabetes and pregnancy preconception?
preconception: glycemic control, folic acid 5mg, dietary advice, retinal and renal assessment pregnancy: optimise glucose control - insulin requirements will increase, watch for ketonuria/infections, retinal assessment at 28 & 34 weeks
53
What blood sugars are optimal during pregnancy?
<5.3mmol/l Fasting <7.8mmol/l 1 hour postprandial <6.4mmol/l 2 hours postprandial <6mmol/l Before bedtime
54
What is the management of diabetes regarding birth?
observe for PET labour: 38-40 weeks or earlier - consider C section if macrosomnia blood sugar - maintain with insulin and dextrose insulin solution CTG monitoring early feeding: to prevent hypoglycaemia
55
what are the risk factors for gestation diabetes mellitus?
- BMI >30 - previous macrosomic baby > 4.5kg - previous GDM - FMH of diabetes - women from high risk groups for developing diabetes – eg. Asian origin - polyhydramnios or big baby in current pregnancy - recurrent glycosuria in current pregnancy
56
what is GDM associated with?
``` increase in: maternal complications (eg PET) fetal complications (macrosomia) ``` but much less than with type I or II diabetes
57
how is GDM managed?
control blood sugars: metformin and diet (insulin may be required) post delivery: check OGTT 6-8 weeks yearly check on Hb1AC/blood sugars as at higher risk of developing overt diabetes
58
what are the components of Virchow's triad?
- stasis - hypercoaguability - vessel wall injury
59
why is the risk of VTE increased in pregnancy?
- pregnancy is a hypercoaguable state: protects mother against bleeding post delivery - increased stasis: progesterone, effects of enlarged uterus - may be vascular damage at delivery/ C section
60
what are the risk factors for VTE in pregnancy?
high: age, BMI health: dehydration, infections, decreased mobility, PET, haemorrhage habits: IV drug users history: VTE, FMH, thrombophilia, sickle cell disease
61
what is the prophylaxis fro VTE in pregnancy?
TED stockings advice increased mobility, hydration prophylactic anti-coagulation with 3 or more risk factors
62
what are the signs and symptoms of VTE?
- pain in calf - increase girth of affected leg - calf muscle tenderness - breathlessness - pain on breathing - cough - tachycardia - hypoxic - pleural rub
63
How is VTE investigated in pregnancy?
- ECG - blood gases - doppler - V/Q lung scan - CT pulmonary angiogram
64
How is VTE treated in pregnancy?
anticoagulation

reproductive system (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions