Pregnancy Pathophysiology

Question 1

When does a spontaneous abortion take place?

Answer 1

Prior to 20 weeks gestation

Question 2

How is recurrent abortion defined?

Answer 2

2-3 spontaneous abortions

Question 3

How is a threatened abortion defined?

Answer 3

Symptoms of abortion (i.e. cramping/bleeding) but fetus remains viable and os closed

Question 4

Approximately how many pregnancies in the first trimester result in spontaneous abortion associated with genetic abnormalities?

Answer 4

30%

Question 5

What is an inevitable abortion?

Answer 5

Os is open, POC will be passed

Question 6

What is the most common reason for spontaneous abortion?

Answer 6

Genetic alterations

Question 7

What maternal abnormalities can cause spontaneous abortion?

Answer 7

Fibroids
Intrauterine scarring
Trauma
Cervical insufficiency

Question 8

What are the pathogens most commonly associated with septic abortion?

Answer 8

Enterobacteriaceae
Strep
Staph

Question 9

What structure supports nutrients and development of the fetus?

Answer 9

Yolk Sac

Question 10

What cells initially become the placenta?

Answer 10

Syncytiotrophoblasts

Question 11

What day of gestation does the fetal heart begin to contract?

Answer 11

Day 21

Question 12

What day of gestation does the placenta develop function?

Answer 12

Day 16

Question 13

What is placental abruption?

Answer 13

Premature seperation (can be partial or completion) of placental form to end of uterine lining

Question 14

Where does the placenta develop in placenta previa?

Answer 14

Over the cervix

Question 15

What increases the risk of placenta previa?

Answer 15

C-section, multiple gestation, or other trauma

Question 16

Where does an ectopic most commonly occur?

Answer 16

Fallopian Tube

Question 17

What is the number one risk factor for ectopic pregnancy?

Answer 17

Previous ectopic pregnancy

Question 18

What is the presentation of ectopic pregnancy?

Answer 18

• POOP typically 6-8 wks after LMP
• Pain typically along one of the lower quadrants
• Vaginal bleeding
• Maybe in shock
• Syncope

Question 19

What medication can be used early in pregnancy to abort an ectopic pregnancy?

Answer 19

Methotrexate

Question 20

What is the problem for the fetus in cord prolapse?

Answer 20

Decreased oxygen to the fetus

Question 21

When does preeclampsia typically present?

Answer 21

Typically 2nd trimester

Question 22

If spiral arteries remain narrow during pregnancy what will result?

Answer 22

Placenta hypoperfusion

Question 23

What is the treatment for eclampsia?

Answer 23

Magnesium and deliver fetus

Question 24

Seizures are a common presenting symptom in what pregnancy complication?

Answer 24

Eclampsia

Question 25

What contents make up the membranes?

Answer 25

Fibrous tissue made up of collagen and laminin

Question 26

What is premature rupture of membranes (PROM)?

Answer 26

Membranes rupture, allowing for release of amniotic fluid, prior to beginning of uterine contractions

Question 27

What condition does PROM lead to?

Answer 27

Oligohydramnios

Question 28

How much pressure is on the fetus during each contraction?

Answer 28

25lb

Question 29

When do the membranes typically rupture?

Answer 29

Once the cervix is fully dilated

Question 30

When does secondary postpartum hemorrhage occur?

Answer 30

24hr-12wks after delivery

Question 31

When does primary postpartum hemorrhage occur?

Answer 31

Within 24 hours of delivery

Question 32

When does an amniotic embolism typically occur?

Answer 32

During labor or immediate postpartum

Question 33

What are some risk factors for amniotic embolism?

Answer 33

- Premature delivery - Advanced maternal age - Abnormal attachment site of placenta - Preeclampsia - C-section - Polyhydramnios

Question 34

When is mom at risk for developing cardiomyopathy during pregnancy?

Answer 34

Typically third trimester or after delivery

Question 35

What are the risk factors associated with cardiomyopathy during pregnancy?

Answer 35

- Advanced maternal age - Multiple gestation - Hypertension - African decent - Cocaine

Question 36

When mom has a known collagen disorder or cardiac malformation what is she at high risk for?

Answer 36

Arterial dissection or rupture

Question 37

Is there bleeding associated with a complete placental abruption?

Answer 37

No, blood is contained within the uterus