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Questions and Answers
Which of the following is NOT a possible cause of early bleeding in pregnancy?
Which of the following is NOT a possible cause of early bleeding in pregnancy?
What characterizes a missed abortion?
What characterizes a missed abortion?
Which of the following types of abortion is characterized by severe bacterial infection?
Which of the following types of abortion is characterized by severe bacterial infection?
What is the clinical management recommended for a threatened abortion?
What is the clinical management recommended for a threatened abortion?
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Which condition is defined as the termination of pregnancy before the viability of the fetus?
Which condition is defined as the termination of pregnancy before the viability of the fetus?
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In the event of inevitable abortion, which symptom is usually present?
In the event of inevitable abortion, which symptom is usually present?
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What is a common site for ectopic pregnancy?
What is a common site for ectopic pregnancy?
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How is a recurrent abortion defined?
How is a recurrent abortion defined?
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Which of the following is NOT considered a maternal/fetal cause of abortion?
Which of the following is NOT considered a maternal/fetal cause of abortion?
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What is a significant risk factor for the development of ectopic pregnancy?
What is a significant risk factor for the development of ectopic pregnancy?
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What is the primary reason for the delivery of a patient diagnosed with abruptio placenta?
What is the primary reason for the delivery of a patient diagnosed with abruptio placenta?
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What is the characteristic color of blood typically found in ectopic pregnancy?
What is the characteristic color of blood typically found in ectopic pregnancy?
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Which type of hemorrhage is characterized by blood retained inside the uterus?
Which type of hemorrhage is characterized by blood retained inside the uterus?
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What is a common symptom indicating the presence of abruptio placenta?
What is a common symptom indicating the presence of abruptio placenta?
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Which surgical procedure is primarily performed when a healthy fallopian tube is present in the case of ectopic pregnancy?
Which surgical procedure is primarily performed when a healthy fallopian tube is present in the case of ectopic pregnancy?
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Which factor is NOT typically associated with the etiology of abruptio placenta?
Which factor is NOT typically associated with the etiology of abruptio placenta?
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What is a typical symptom when diagnosing a complete vesicular mole?
What is a typical symptom when diagnosing a complete vesicular mole?
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What significant sign may develop in 20% of gestations involving a vesicular mole?
What significant sign may develop in 20% of gestations involving a vesicular mole?
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In cases of abruptio placenta, which examination finding would be expected during a general assessment?
In cases of abruptio placenta, which examination finding would be expected during a general assessment?
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What is the critical feature of placenta previa during diagnosis?
What is the critical feature of placenta previa during diagnosis?
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What is a crucial nursing intervention when caring for a patient experiencing bleeding during pregnancy?
What is a crucial nursing intervention when caring for a patient experiencing bleeding during pregnancy?
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Which treatment method is considered first-line if the bleeding is not severe in a patient with abruptio placenta?
Which treatment method is considered first-line if the bleeding is not severe in a patient with abruptio placenta?
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What is typically detected during the abdominal examination of a patient with an ectopic pregnancy?
What is typically detected during the abdominal examination of a patient with an ectopic pregnancy?
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What type of surgical procedure is suction evacuation considered for managing a vesicular mole?
What type of surgical procedure is suction evacuation considered for managing a vesicular mole?
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What condition is associated with an increased risk of abruptio placenta?
What condition is associated with an increased risk of abruptio placenta?
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What should be monitored closely in a patient exhibiting signs of shock due to abruptio placenta?
What should be monitored closely in a patient exhibiting signs of shock due to abruptio placenta?
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In late pregnancy, what indicates marginal separation of the placenta?
In late pregnancy, what indicates marginal separation of the placenta?
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Which lab investigation is NOT typically required for a patient with abruptio placenta?
Which lab investigation is NOT typically required for a patient with abruptio placenta?
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What does the serum β-hCG level indicate in the case of a vesicular mole?
What does the serum β-hCG level indicate in the case of a vesicular mole?
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Which type of placenta previa involves the placenta covering the internal os completely?
Which type of placenta previa involves the placenta covering the internal os completely?
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What is the definition of incomplete abortion?
What is the definition of incomplete abortion?
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Which symptom is NOT associated with a missed abortion?
Which symptom is NOT associated with a missed abortion?
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What is a significant treatment option for septic abortion?
What is a significant treatment option for septic abortion?
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In complete abortion, which of the following statements is true?
In complete abortion, which of the following statements is true?
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Which type of abortion is characterized by a medical indication?
Which type of abortion is characterized by a medical indication?
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What vital signs changes may indicate septic abortion?
What vital signs changes may indicate septic abortion?
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Which complication is associated with habitual abortion?
Which complication is associated with habitual abortion?
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What is a characteristic finding in the ultrasound of a missed abortion?
What is a characteristic finding in the ultrasound of a missed abortion?
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What action should be taken if a patient is experiencing incomplete abortion?
What action should be taken if a patient is experiencing incomplete abortion?
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Study Notes
Causes of Bleeding in Early Pregnancy
- Abortion: Termination of pregnancy before fetal viability (before 28 weeks gestation). Causes include endocrine issues, infections, environmental toxins (like alcohol and smoking), trauma, maternal anoxia, malnutrition, psychological stress, uterine abnormalities, fetal chromosomal abnormalities, and idiopathic factors.
- Ectopic Pregnancy: Fertilized ovum implants outside the uterus. Common site is the fallopian tubes (95%). Other less common sites include ovaries, broad ligaments, peritoneum, and cervix. Potential outcomes are tubal mole, tubal abortion, or tubal rupture.
- Hydatidiform Mole: A benign neoplasm of the chorionic villi. Characterized by abnormal growth in the uterine cavity, absence of a fetus, and possible exaggeration of pregnancy symptoms, along with vaginal bleeding. Can lead to complications like preeclampsia or hyperthyroidism.
- Local Gynaecological Lesions: Cervical ectopy, polyps, dysplasia, carcinoma, and ruptured varicose veins can also cause bleeding.
Types of Abortion
- Threatened Abortion: Mild vaginal bleeding and cramping, closed cervix; fetus is viable. Management focuses on bed rest and supportive care.
- Inevitable Abortion: Excessive vaginal bleeding and cramping, dilated cervix; fetus is non-viable. Uterine evacuation (medically or surgically) is necessary.
- Incomplete Abortion: Retained products of conception inside the uterus (part of placenta, or entire fetus). Heavy vaginal bleeding and cramping, an open cervix. Management: similar to inevitable abortion.
- Complete Abortion: All products of conception expelled; minimal bleeding, closed cervix, uterus reduced in size. No further treatment needed.
- Missed Abortion: Retained dead products of conception for 4 or more weeks. Regression of pregnancy symptoms, no growth in abdomen, no fetal movement, possibly "prune-juice" discharge. Cervix and uterus are closed initially. Pregnancy tests will become negative. Ultrasound confirms fetal death.
- Septic Abortion: Any type of abortion complicated by infection. Common causes include bacteria (E. coli, bacteroids, anaerobic streptococci, clostridia, streptococci, staphylococci). Typically presents with fever, tachycardia, rigors, malaise, and suprapubic pain with vaginal discharge. Management: Isolation, IV antibiotics, fluid therapy, and surgical evacuation.
- Recurrent Abortion: Three or more successive spontaneous abortions
Ectopic Pregnancy
- Definition: Implantation of a fertilized ovum outside the uterus.
- Clinical Picture: Amenorrhea (usually short), pain (aching, colicky, stabbing depending on the stage), light vaginal bleeding (dark brown color possible), and lower abdominal tenderness. Uterus enlarged, soft, and tender.
- Diagnosis: Differentiate it from other causes of bleeding in early pregnancy using physical exam, symptom analysis, and diagnostic tests.
Hydatidiform Mole
- Definition: Benign neoplasm of the chorionic villi. No fetus or normal embryo.
- Clinical Picture: Short amenorrhea, exaggerated pregnancy symptoms, vaginal bleeding (brown, possible vesicles), potential abdominal pain (dull or colicky), enlarged uterus with a 'doughy' consistency; absence of fetal heartbeat.
- Diagnosis: Confirmed using urine pregnancy tests (highly positive), serum beta-hCG levels (extremely high), and ultrasound ("snow storm" appearance).
Bleeding in Late Pregnancy
- Placenta Previa: Placenta implants in the lower uterine segment; painless vaginal bleeding after 28 weeks. May or may not be recurrent.
- Abruptio Placenta: Premature separation of a normally implanted placenta; severe abdominal pain, vaginal bleeding (dark or concealed), potentially high risk of fetal death, uterine tenderness, hardness or rigidity.
- Vasa Praevia: Exceptionally rare; blood vessels of the umbilical cord traverse the membranes just above the cervix. Bleeding risk and possible fetal death.
Nursing Care for Bleeding with Pregnancy
- Monitoring: Blood loss assessment, pain levels, uterine contractions, and maternal vital signs.
- Emotional support: Addressing client anxieties and fears.
- Laboratory investigations: CBC, blood typing, coagulation studies.
- Aseptic technique: Infection prevention measures.
- Fetal monitoring: Auscultation of fetal heart rate.
- Fluid balance: Recording intake and output.
- Bed rest: Following medical advice for proper rest and recovery.
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Description
This quiz explores the various causes of bleeding during early pregnancy, including abortion, ectopic pregnancies, hydatidiform moles, and local gynecological lesions. Understand the implications of each condition, their symptoms, and potential complications. Perfect for those studying gynecology and women's health.
