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24 Cards in this Set
- Front
- Back
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When is serum bHCG first detectable after ovulation?
- lvls peak when? What else can be used to dx pregnancy? |
6-12d
- ~10wk Progesterone >25ng/mL |
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What is the 5-10-20 rule wrt early pregnancy?
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5mm fetal pole (CRL): Heart beat
10mm gestational sac: Yolk sac 20mm gestational sac: Fetal pole |
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Order the likelihood of the following being related to spontaneous abortion (SAB):
- Triploidy, Trisomy, Monosomy |
Trisomy > Mono > Triploidy
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If at 6wks and 8wks you can see a fetal ______, risk of miscarriage drops significantly.
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fetal heartbeat.
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Is spotting in the 1st trimester a sign of miscarrage?
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40% of all women will spot in the first tri, of those, 50% of those will miscarry.
Not all bleeding is created equal. |
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If you have bleeding in the first Trimester, you automatically have had a threatened abortion.
T/F? |
True
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What is an embryonic demise?
Missed abortion? Anembryonic demise? inevitable abortion? |
US dx of pregnancy w/o heartbeat.
when you don't make the 5-10-20 rules. cervix is already dilated. |
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What is the most common genetic anomaly found in miscarriage (according to our lecturer)?
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Turners.
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Most genetic errors occur when?
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gametogenesis.
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Can various thromboembolic dz be a cause of miscarriage?
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yes. (Factor V lieden, etc.)
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What are the important labs you always run on someone w/ pregnancy? (3)
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bHCG, CBC, Blood type (Rh status, etc.)
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Chances of a pt having another miscarriage don't increase until they've already had __ miscarriages before (#).
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3.
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Where do most ectopic pregnancies take place? If it happens in the interstitial area b/t the tube and the uterus, is that more or less dangerous?
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ampullary of the fallopian tube.
more. |
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IUD in place and manages to get pregnant, this gives a 3 fold increase in risk of what?
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ectopic pregnancy.
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How does an ectopic pregnancy present?
What are some early labs you might order? |
abdominal pain, absences of menses, irregular vaginal bleeding, shoulder pain, dizziness/syncope.
CBC, Type and screen (Blood type/screen), bHCG, [AST, ALT, Cr, etc for medical management] |
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Which ectopic pregnancies are canditates for methotrexate tx?
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unruptured
<4cm no evidence of active bleed no hepatic, hematologic, renal dz RELIABLE PTS ONLY, b/c these pts have to keep coming back reliably for labs. |
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What is GTD (gestation trophoblastic dz)?
Types? |
normal tissue --> becomes cancerous.
hydatidiform mole (80% of em) invasive (10-15%) Choriocarcinoma (2-5%) Placental-site trophoblastic tumor (v. rare) |
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What are risk factors for molar pregnancies re: age? ethnicity?
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<20 >40
Southeast Asian |
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Of all Benign GTD (hydatidaform), what % are complete?
- what does complete mean? - incomplete? ever metastatic? |
90%
- all paternal chromosomes present, NO fetal tissue present. - 69XXY (ovum fertilzed by two sperm)... HAS fetus... very very rarely metastatic. |
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How does GTD present?
- bHCG? - US? do incomplete moles have more or less severe sx usually? |
Abnormal vaginal bleeding,
MARKEDLY elevated bHCG >>>100,000 sometimes. "Snowstorm" pattern: fluid filled hydropic villi typically less. |
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What is the tx for a molar pregnancy?
- folllow up how? |
evacuate the uterus, hysterectomy is the pt is done childbearing.
CLOSE followup w/ bHCG lvls until negative (weekly), and then monthly once negative for a year. |
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What do we do for persistant moles confined to the uterus?
ones that have gone metastatic? |
methotrexate +/- hysterectomy
methotrexate if low risk, multi-agent chemo if high risk. |
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If a pt has had a mole previously, and then gives a normal birth, what should be done post-partum?
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placenta should be checked and bHCG should be checked 6wks post.
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What lvl should be followed in cases of placental-site trophoblastic tumor (very rare variant of GTD)?
- do you see synctiotrophoblastic cells? - arises from mole or normal pregnancy? |
placental lactogen (hPL).
- no - can be either. |
