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48 Cards in this Set
- Front
- Back
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Methotrexate used
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ectopic abortion stable
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What ist most common cause of maternal death of first trimester
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Ectopic preg undiagnosed
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Ectopic preg sx
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backache
shock vaginal hemorrhage or spotting syncope abdominal distension pelvic exam reveals adnexal tenderness |
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IUD use associated with
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Ectopic pregnancy
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Rupture is usually spontaneous and occurs
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ectopic preg and 6-16
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Quantitative hCG is less in an
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ectopic pregnancy, slow rise or a plateua
1/3 of ectopic preg have normally rising hCG |
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low hcg
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spontaneous abortion
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high hcg
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complete hydatidorm mole
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US can see IUP when
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6 wks gestation
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empty uterine cavity suggestsz
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ectopic
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hCG value of 2000 or more and no products of conception are detected by TV ultrasound
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ectopic pregnancy
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ectopic pregnancy to use in unstable pateints
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laparotomy
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management of women with early, unruptured ectopics
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medical
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ectopic patients who are hemodynamically unstable or with contraindications to medical management
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laparatomy for unstable
laparscopy for stable |
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og/gyn consult on all
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ectopic
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rh immunoglobulin given in
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ectopic pregnancy with Rh- neg mother
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incidence of ectopic preg
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1 in 150
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ectopic preg is a surgical emergency in what % of cases
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15-20
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% of spontaneous abortion in clinically recognized pregnancies
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10-20% of clinically rec preg
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spontaneous abortion
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loss of fetus less than 20 weeks
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most spontaneous abortions result from
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chromosomal defects due to maternal or paternal
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spont abortion causes
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chrom defects, UTI, homonal imbalaces,
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2nd trimester spont abortion causes most common
12-20 weeks |
problems w uterus structure or incompetent cervix
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spon abortion risk factorfs
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maternal age
smoking alc use infec |
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what to ask during history of spon abortion
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last menst period normal?
-30-40% of all pregnant women will have some bleeding during early pregnancy blood type -quantity, prior preg and complications, pain and cramping, prenatal care |
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bleeding spontaneous abortion less than 20 weeks do what
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Do a pelvic exam on every female of child-bearing age with lower abdominal pain, especially if pregnant
determine amount of vaginal bleeding cervical dilation cervical effacement look for POCs check for adnexal tenderness or masses |
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phys exam of spon abortion
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vitals, hypotension, fever, amonut of blood, pocs,
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fetus & placenta are expelled
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complete abortion
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inevitable abortion
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dilated cervix no passage of products
bleeding, cramping, mayb ruptured membranes |
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threatened abortion
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bleeding but no cervical dilation, pregnancy continues
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missed abortion
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fetal demise, no utrerine activity to expel poc, no pain
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incomplete
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some but not all products of ocnception have been passed
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incompetent cervix vs spon abortion?
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incompetent cervix has silent, painless dilation,
usually occurs between 16-28 wks of gestation |
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spon abortion studies
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preg hormone levels will be falling
serial hcg levels are very helpful, do 2 days apart hemoglobin to check how much they bled rh type send tissue to pathology coag panel if hemorrhag is suspected |
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hcg levels for preg
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above 25
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hcg levels for not preg
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less than 5
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level of 100 iu/l is reached when
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about the day of expected menses
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for 30 days of normal gestation the level doubles every
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2.2 days
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gestation sac seen when?
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5-6 weeks w tv
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fetal pole vis when?
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6 wks
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tx for threatened abortion
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take a nap but no sex
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incomplete or inevitable tx
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prompt removal of products with d&c
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missed abortion tx
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counseling and elective termination, d&c
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recurrent abortion def
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3 or more 1st trimester abortions
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septic abortion def
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abortion assoc w utrine infection
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causes of recurrent abortion
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polycystic ovaries, diabetes, thyroid disease, bleeding, cervical incom, congenital abor, chromosal abnom
see specialist |
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blighted ovum def
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also called anembryonic preg
fertilized egg implants into uterine wall but fetal dev never begins gest sac w or w/o yolk sac but there is absence of fetal growth |
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molar pregnancy
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genetic error during fertilizatoin
growth of abnormal tissue hcg may be greater |
