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7 Cards in this Set
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What % of 1st trimester bleeding will miscarry?
What are Chadwick's sign, Hegar's sign: B-HCG levels in 1st 20 weeks: |
30-50%
Chadwick's sign - ~6 weeks, blue cervix, vagina Hegar's sign - ~8 weeks, softening of cervica isthmus detectable 8 days after LH surge 1st missed period - 100-600 100,000 by 8 weeks ~10,000 by 20 weeks |
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Explain HCG changes in normal, ectopic, multiple gestations, Down's:
When to give Rhogam: First dx in differential of bleeding: Presentation of implantation bleeding: |
normal - double ~2d.
ectopic - <66% increased in 2 d. multiple - >200,000 Down's - HCG >2x normal RH negative, Ab negative w/ vaginal bleeding related to pregnancy ectopic pinkish D/C in vagina, closed cervical os, otherwise normal; U/S correlates w/ HCG |
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Crampy pelvic pain, vaginal bleeding, closed cervical os, HCG increases normally:
vaginal bleeding, open cervical os: What is a missed abortion? S/S of incomplete abortion: |
threatened abortion
inevitable abortion varied clinical findings, no embryonic cardiac motion vag bleed, benign/tender exam, open cervical os, plateau or falling HCG, thickened/irregulat endometrium, echogenic debris |
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S/S of complete abortion:
Complete molar pregnancy: incomplete molar pregnancy: S/S, appearance on U/S: |
vag bleed, benign exam, closed cervical os, falling HCG, empy uterus
46XX, dispermy, risk of mets, no fetal tissue 69XXY, fetal tissue present abnormal bleeding, hydropic villi, grape-like appearance, N/V, hypothryoid S/S; "snowstorm" appearnce on U/S |
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Explain disappearing twin syndrome:
Major causes of late vag bleeds (>20 weeks): |
twins dx'ed < 10 weeks - 71% single
dx'ed 10-15 weeks - 63% single dx'ed >15 weeks - no vanishing twins upper genitals (uteroplacental), abruption, placenta previa |
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What is an abruption?
Clinical presentation: Primarily dx'ed based on what? Is U/S useful for abruption? |
premature separation of placenta - >20 weeks
vag bleed, abd pain, tachysystole, non-reassuring FHR fetal - decreased O2 diffusion, maternal hypotension, asphyxia dx primarily on clinical impression U/S not useful - poor sensitivity |
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Some labs suggestive of abruption:
Definition of placenta previa: General presentation and clinical points: Uterine rupture usually occurs when? |
low fibrinogen, high platelets
abnormal implantation, covers cervical os usually painless (signal) bleeding, bleeding usually quits if no labor; DON'T do digital exam, use U/S to locate placenta during active labor |
