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28 Cards in this Set
- Front
- Back
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Leading causes of maternal death
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Thromboemboli disease, hypertensive disease, hemorrhage, infection, and ectopic pregnancy
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Definition of high-risk pregnancy
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One in which the mother, fetus or newborn is at or may possibly be at increased risk of morbidity or mortality before, during or after delivery
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Neonatal mortality
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Infants weighing >500gUp to 28 days of life
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Definition of abortion
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Before 20th weeks gestation, Based on LMPOr delivery of fetusWeight less than 500 grams
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Etiology of spontaneous abortion
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50% of SA during the first 12 weeks with abnormal karyotype (Aneuploidy)Abnormal development noted in majority of cases,Incomplete cervix cause of second trimester loss,Maternal factors,Toxic factors, Trauma
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Abortion classification
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Threatened abortionInevitable abortionComplete abortionMissed abortionSeptic abortion
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Threatened abortion
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Bleeding during early pregnancyPrognosis worse with pain or crampingRule out other course of bleedingCervical lesionsPolypsImplantation bleeding
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Inevitable abortion
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Certain to occurRupture of membranesCervical dilation
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Incomplete abortion
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In gestation after 10 weeksA portion of the products retained in the uterusCrampsPersistent and severe bleeding
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Missed abortion
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Missed abortion refers to the clinical situation in which an intrauterine pregnancy is present but no longer developing normally.
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septic abortion
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a form of miscarriage that is associated with a serious uterine infection
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Management of threatened abortion
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Serial hCGSerial progesteroneVaginal sonogramsPelvic restBed rest
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Management of inevitable or incomplete abortion
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Evacuation of the uterus by suction D and C .Prognosis is excellent if the retained tissue is promptly and completely evacuated
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ECTOPIC PREGNANCY
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A fertilized ovum implants in an area other than the endometrial lining of the uterus.
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Time of Rupture of ectopic pregnancy
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Rupture is usually spontaneousIsthmic pregnancies 6-8 week’s gestationAmpullary pregnancies 8-12 week’s gestationInterstitial pregnancies 12-16 weeks’s gestation
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Define Culdocentesis
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Culdocentesis is a medical procedure involving the extraction of fluid from the rectouterine pouch posterior to the vagina through a needle. It can be one diagnostic technique used in identifying pelvic inflammatory disease (in which case purulent fluid will be extracted) and ectopic pregnancy.
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differential diagnosis of ectopic pregnancy
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AbortionAcute salpingitisHemorrhagic corpus luteumAcute appendicitisOvarian cyst torsion
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define preeclampsia
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Persistent hypertension from gestation 20th week onwards defined by either:Diastolic bp >90 Torr,Systolic bp >140 Torr,Or relative increase diastolic bp >15 Torr or systolic bp>25 TorrProteinuria > 0.3g in 24 hours,Generalised oedema (mainly lower extremities, hands)
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definition eclampsia
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One or more convulsion, not caused by other cerebral condition, in a patient with pre-eclampsia
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Placenta previa
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Placenta previa is a condition that may occur during pregnancy when the placenta implants in the lower part of the uterus and obstructs the cervical opening to the vagina (birth canal).
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risk factors of Placenta previa
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Multiparity (previous deliveries)Multiple pregnancyPrevious myomectomy (removal of uterine fibroids through an incision in the uterus)A previous C-section (if the scar is low and close to the vaginal cervix region).
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Mechanisms of bleeding
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Mechanical separation of the placenta from its implantation sitePlacentitisRupture of poorly supported venous lakes in the deciduas basalis
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Classification of Placenta previa
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Total placenta previaThe internal cervical os is covered completely by placentaPartial placenta previaThe internal os is partially covered by placentaMarginal placenta previaThe edge of the placenta is at the margin of the intenal os.
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Differential diagnosis Placenta previa
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Placental abruption;vagina bleeding with pain, tenderness of uterus. Vascular previa;Abnormality of cervix;cervical erosion or polyp or cancer
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ABRUPTIO PLACENTAE
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premature separation of the normally implanted placenta from the uterine wall,1/77-89 deliveries Severe form (resulting in fetal death)1/500-750
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Mechanism ABRUPTIO PLACENTAE
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hemorrhage into the decidua basalis, leading to premature placental separation and further bleeding.
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associated factors of ABRUPTIO PLACENTAE
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Associated factors:Maternal hypertensionSudden decompression of the uterusMaternal age and multiparity trauma
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Complication of ABRUPTIO PLACENTAE
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DICShockAmniotic fluid embolismAcute renal dysfunction
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