WEEK 3 Flashcards

Question

What is the complete of a threatened spontaneous miscarriage?

Answer 1

Expulsion of all products of conception | – embryo, placenta and intact membranes

Answer 2

 Usually occurs < the 8th week of gestation  Pain (A/A)  Vaginal loss – slight. → mod; bright red → brown

Answer 3

Not all products of conception are expelled. – Foetus usually expelled but part of placenta is retained

Answer 4

 Usually occurs >8 weeks but < 20 weeks  Bleeding mod → profuse  Abdominal pain &/or backache ++++  Risk of cervical shock if foetus caught in cervix

Answer 5

Infection due to lack of removal of the products of | conception

Answer 6

 History of abortion  Unwell, headache, nausea, sweating & shivering, flushed/hot skin, ↑ temp, abdo pain  Tender uterus- bulky, offensive vaginal discharge, may be pinkish in color

Answer 7

Pain- – central, in low abdomen, – intermittent backache Vaginal bleeding- blood stained discharge – brown spotting/bright red loss • Minimal → heavy May experience – Uneasiness prior to onset of symptoms

Answer 8

where products of coneption partially caught in cervix - signs of shock not due to hypovolaemia

Answer 9

- past Hx of miscarriage - potential miscarriage on ultrasound - smoking - obesity

Answer 10

− Pain – cramps; signs of pregnancy ? Subsiding; PV loss; light or heavy bleeding – with jelly like clots; may have nausea or tender breasts − Level of shock out of proportion to blood loss

Answer 11

Fertilized ovum embeds outside the uterine cavity, usually in the fallopian tubes

Answer 12

- cervical - peritoneal - interstitial - tubal (isthmus) - Tubal (ampullar) - Infundibular (osital) - Ovarian - Abdominal

Answer 13

 Narrowing of the tube – ?oedema ?inflammation ?infection  Kinking of tube – ?adhesions ? Scarring  Damage to lining of tube – endometriosis or PID; smoking  Delay in transit of ovum; mini pill – Previous surgery;  IVF-tubal surgery

Answer 14

- History of amenorrhea  Mild lower abdominal pain- – occasionally sharp, stabbing; ↑ intensity over a few days especially with bowels; tenderness on one side; rebound tenderness; adnexal tenderness  Shoulder tip pain (KEY MARKER)  Tachycardia  Postural hypotension  Dizziness and fainting  Nausea & diarrhoea  +/- bleeding or slight brown discharge  U/S: Uterus empty

Answer 15

 Sudden severe abdominal pain  Profound shock- collapse  Vaginal Bleeding - minimal  Referred shoulder tip pain

Answer 16

Painless dilatation of cervix; the foetus, placenta & | membranes completely expelled

Answer 17

Unknown - ? weakness of retaining sphincter | mechanism at the junction of the uterus & cervix;

Answer 18

Painless delivery of foetus b/n 16-23/40

Answer 19

endometrium of upper uterus

Answer 20

1/6 of baby weight

Answer 21

transfer nutrients and excretory products via diffusion no mixingof maternal and foetal blood

Answer 22

 Nutritive – Amino acids; simple sugars  Respiratory – O & CO2 exchange  Excretory – Waste products  Endocrine – βHCG; HPL; Oestrogens, Progesterone,  Barrier – For most but not all

Answer 23

 Bleeding from the birth canal in excess of 15mls from the 20th (approx) week of gestation to the birth of the neonate

Answer 24

 Placenta Praevia  Placental abruption  Vaso praevia

Answer 25

* Maternal age >40 * Complex medical history prior to pregnancy * Multigravida * Known placenta praevia * History of abruption * Coagulopathies * Use of Crack Cocaine

Answer 26

Placenta partially or wholly | implanted in the lower part of the uterus.

Answer 27

• Can start spotting from 28 weeks • more severe around 32-36 weeks

Answer 28

 1 - placenta lies in lower segment but does not reach the internal os  2 - edge of placenta is attached to lower segment of uterus & reaches internal os  3 - edge just covers internal os -bleeds once cervix starts to dilate past 3-4cm  4 - placenta centrally covers the internal os - torrential haemorrhage is likely

Answer 29

```  Painless recurrent bleed of various amounts – tends to be BRIGHT RED  Dx by transvaginal ultrasound  Premature labour  Shock  Foetal malpresentation ```

Answer 30

 (type 1) Foetal vessels crossing or running in close proximity to the inner cervical os. ```  (Type 2) Vessels course within the membranes (unsupported by the umbilical cord or placental tissue) ```

Answer 31

 Can be detected on transvaginal U/Sound – 2nd trimester  Painless Vaginal bleeding – fresh blood – Usually limited; non continuous – Usually when the membranes rupture  Lack of foetal movements – After membranes rupture  Usually late 3rd trimester of pregnancy – Associated with labour

Answer 32

``` Premature separation of the placenta from the uterine lining (after 20 weeks) ```

Answer 33

 Occurs in 3-5% of all pregnancies

Answer 34

– bleeding from maternal venous sinuses into placental bed → further separates placenta → blood retained behind placenta → infiltrates myometrium → extravasation causing marked damage such as bruising & oedema

Answer 35

```  Presence of complex medical disorders before pregnancy  Substance abuse especially methamphetamine use  Multi gravida  Maternal age over 40  Previous history of abruption  Hypertension  Pre-eclampsia  Trauma  Unknown ```

Answer 36

• Central/concealed - Separation is in the middle • Revealed/marginal - Separation is near the edge of the placenta • Partially revealed - Combination of both of the above

Answer 37

 Vaginal bleeding may or may not occur (depending on type)  ↑ Pulse ↓ BP, hypovolaemic shock,  Abdo pain ++  Tender uterus  Anxious; “impending doom” → Concealed bleeding into uterine muscle → Causes uterine enlargement → Extreme pain & hard & rigid abdomen

Answer 38

 Disseminated Intravascular coagulation (DIC)- – inappropriate coagulation within blood vessels  Post partum Haemorrhage (PPH)  Renal failure  Pituitary necrosis  Distressed baby  Foetal death in-utero (FDIU)

Answer 39

 Tear in the uterus – often associated with prior caesarean section

Answer 40

 Previous caesarean section  Other uterine surgery or termination of pregnancy  Grand multiparity (>6)  Undiagnosed cephlopelvic disproportion  Macrosomic (large) baby  Placenta percreta  External cephalic version  Uterine abnormalities

Answer 41

 If in labour – Sudden cessation of contractions – Elevation of the presenting part  Severe constant pain  Foetal death (FDIU)  Maternal shock disproportionate with clinical signs – Concealed haemorrhage

WEEK 3 Flashcards

(65 cards)