Exam 3 - Complications of Pregnancy

Question 1

rare mass, or growth, that forms inside the womb (uterus) at the beginning of pregnancy

Answer 1

Hydatidiform Mole

Question 2

2 types of Hydatidiform Moles

Answer 2

Complete/Classic - no identifiable fetal tissue

Partial - some recognizable fetal tissue

Question 3

Risk Factors: Hydatidiform Mole

Answer 3

Teenagers
Women over 35
Previous miscarriage

Question 4

Signs & Symptoms: Hydatidiform Mole

Answer 4

Vaginal Bleeding (97%)
Hyperemesis
Preeclampsia (27%) - atypical due to first tri
Hyperthyroidism

Question 5

Signs & Symptoms: Incomplete Hydatidiform Mole

Answer 5

Vaginal bleeding

Absence of fetal heart tones

Question 6

Dx: Hydatidiform mole

Answer 6

Ultrasound
“snowstorm” pattern
HCG levels will be elevated

Question 7

Tx: Hydatidiform mole

Answer 7

Evacuation and curettage
OR
Hysterectomy

Question 8

What percentage of Hydatidiform moles develop as a malignancy

Answer 8

20%

Question 9

what should be tested monthly and for how long when performing Hydatidiform mole follow up?

Answer 9

bHCG levels for 6-12 months

Question 10

how long should contraception be used during the entire follow-up period for Hydatidiform moles?

Answer 10

at least 1 year

Question 11

any pregnancy that occurs outside of the uterine cavity

Answer 11

Ectopic pregnancy

Question 12

what is the MC location of Ectopic Pregnancies?

Answer 12

Tubal (97%)

Question 13

top 3 risk factors of Ectopic Pregnancy

Answer 13

previous tubal surgery
previous ectopic pregnancy
in utero DES exposure (used until 1971)

Question 14

Clinical Presentation: Ectopic Pregnancy

Answer 14

women of reproductive age
abdominal pain
vaginal bleeding (~7 weeks after amenorrhea)

Question 15

Exam Findings: Ectopic Pregnancy

Answer 15

normal/slightly enlarged uterus
vaginal bleeding
pelvic pain with manipulation of cervix
palpable adnexal mass

Question 16

suspect ectopic pregnancy rupture if…

Answer 16

significant abdominal tenderness

especially if accompanied by:
hypotension, abdominal guarding, rebound tenderness

Question 17

test of choice for Ectopic pregnancy dx

Answer 17

Ultrasound

Question 18

which folic acid antagonist is used as a medical tx for ectopic pregnancy?

Answer 18

Methotrexate

Question 19

approximately what % of women have difficulty conceiving after an ectopic pregnancy?

Answer 19

30%

Question 20

spontaneous abortion (SA) is classified as pregnancy loss at

Question 21

a pregnancy complicated by BLEEDING before 20 weeks gestation

Answer 21

“Threatened abortion”

Question 22

the CERVIX HAS DILATED, but the products of conception have not been expelled

Answer 22

“Inevitable abortion”

Question 23

ALL PRODUCTS of conception have been passed w/o need for surgical or medical intervention

Answer 23

“Complete abortion”

Question 24

some, BUT NOT ALL, of the products of conception have been passed; retained products may be part of the fetus, placenta, or membranes

Answer 24

“Incomplete abortion”

Question 25

a pregnancy in which there is a fetal demise (usually for a number of weeks) but NO UTERINE ACTIVITY to expel the products of conception

Answer 25

“Missed abortion”

Question 26

a spontaneous abortion that is complicated by intrauterine INFECTION

Answer 26

“Septic abortion”

Question 27

Three (3) of more consecutive pregnancy losses

Answer 27

“Recurrent spontaneous abortion”

Question 28

what percentage of pregnancies complicated with bleeding before 20 weeks gestation end in spontaneous abortion?

Answer 28

50%

Question 29

SA occurs in what % of recognized pregnancies?

Answer 29

20%

Question 30

what type of abnormality accounts for 49% of SAs

Answer 30

chromosomal abnormality

Question 31

SA dx

Answer 31

ultrasound
dilated cervix (“inevitable abortion”)
HCG levels
Progesterone levels

Question 32

progesterone levels lower than ___ng per mL means there will be an abortion