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8 Cards in this Set
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Therapeutic dse 3 cc per min Maintaince dse 1 ml per min |
25 mg 1 ampoule 50 cc
Biparental complete Mole. 69 chromosomes 10% tetraepyloid Association with NLRP 7 ( CHROMISOME 10 Q
70% chorio after molar 20 % after TOP 10 % after NL regnancy
Prenatal invasive testing used in 1. Complete mole with nL twin or partial mole 2 abn placenta suc as mesenchymal hyperplasia of placenta
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Pulmonary embolism master 5195 0300 0011 3473 711972 041-502-041 002 820 01 |
1.3/10 000 041 302 04 100 282 002 |
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BP 1 IN 4 . Bp + per or family pp h/o 1 in 2 PP |
suicide 1/ 100 000reg. Psy hospital 1-2 per 1000 birth in general population |
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The majority of histologically proven complete moles are associated with an ultrasound diagnosis of delayed miscarriage or anembryonic pregnancy.
In one study, the accuracy of pre-evacuation diagnosis of molar pregnancy increased with increasing gestational age, 35–40 % before 14 weeks increasing to 60% after 14 weeks.
A further study suggested a 56% detection rate for ultrasound examination |
GTN incidence after a live birth is estimated at 1/50 000. |
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Ploidy status and immunohistochemistry staining for P57 may help in distinguishing partial from complete moles. |
Excessive vaginal bleeding can be associated with molar pregnancy and a senior surgeon directly supervising surgical evacuation is advised. The use of oxytocic infusion prior to completion of the evacuation is not recommended. If the woman is experiencing significant haemorrhage prior to evacuation, surgical evacuation should be expedited and the need for oxytocin infusion weighed up against the risk of tumour embolisation. |
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There is no indication to send products of conception from a terminated viable pregnancy routinely for histological examination. The Royal College of Pathologists recommends that specimens should not be routinely sent for examination if fetal parts are visible. |
There is no clinical indication for the routine use of second uterine evacuation in the management of molar pregnancies. If symptoms are persistent, evaluation of the patient with hCG estimation and ultrasound examination is advised. Several case series have found that there may be a role for second evacuation in selected cases when the hCG is less than 5000 units/litre. |
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The cure rate for women with a score ≤ 6 is almost 100%; the rate for women with a score ≥ 7 is 95%.
Placental site trophoblastic tumour is now recognised as a variant of gestational trophoblastic neoplasia.
It may be treated with surgery because it is less sensitive to chemotherapy. |
development of postpartum GTN requiring chemotherapy occurs at a rate of 1/50 000 births. |
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In a study of 230 women who conceived within 12 months of completing chemotherapy, there was an increased risk of miscarriage and higher rate of termination in women who received multi-agent chemotherapy.
The rate of congenital abnormality was low (1.8%), irrespective of the type of chemotherapy used.
The rate of stillbirth was elevated compared with the normal population (18.6/1000 births). |
The age at menopause for women who receive single-agent chemotherapy is advanced by 1 year
and by 3 years if they receive multi-agent chemotherapy.
An early study of 1377 women treated between 1958 and 1990 showed a 16.6 relative risk ofdeveloping acute myeloid leukaemia.
There was also a 4.6 relative risk for developing colon cancer,
3.4 relative risk for melanoma and
5.79 relative risk for breast cancer in women surviving for morethan 25 years.
If combination chemotherapy is limited to less than 6 months there appears to beno increased risk of secondary cancers.
2 % 3 % relapse after low & high risk woen within 12 months |
