Obstetrics Complications Quiz

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Questions and Answers

What percentage of ectopic pregnancies commonly occur in the ampullary portion of the fallopian tube?

12%

80% (correct)

95%

What is the primary risk associated with a rupture of an ectopic pregnancy in the interstitial portion of the fallopian tube?

Minor blood loss

Severe intraperitoneal bleeding (correct)

Increased chance of miscarriage

Infection risk

What percentage of ectopic pregnancies are typically found in the isthmus of the fallopian tube?

50%

12% (correct)

95%

What occurs in approximately 95% of ectopic pregnancies?

They happen in the fallopian tube. Signup and view all the answers

What complication can result from constant bleeding in the ampullary portion of a fallopian tube during an ectopic pregnancy?

Significant blood loss over time Signup and view all the answers

What symptom is NOT commonly associated with a septic abortion?

Severe headache Signup and view all the answers

Which of the following factors can lead to a septic abortion?

The presence of an intrauterine device (IUD) during pregnancy Signup and view all the answers

What is the consequence of an Rh-negative mother carrying an Rh-positive baby?

Formation of antibodies in the mother Signup and view all the answers

What condition results from the breakdown of red blood cells in the fetus due to Rh incompatibility?

Anemia Signup and view all the answers

What is one common diagnostic method for identifying an ectopic pregnancy?

Transvaginal ultrasound Signup and view all the answers

What causes a sensitized Rh-negative mother to attack her Rh-positive fetus?

Introduction of fetal blood into the maternal circulation Signup and view all the answers

What is the primary risk associated with having tissue left inside the uterus after a miscarriage?

Septic abortion Signup and view all the answers

Which of the following statements about ectopic pregnancy is true?

It involves implantation outside the uterine cavity Signup and view all the answers

What is the primary intervention for a ruptured ectopic pregnancy?

Laparoscopy to ligate bleeding vessels Signup and view all the answers

What is the primary purpose of administering RhIG/RhoGAM after an ectopic pregnancy for women with Rh-negative blood?

To prevent isoimmunization in future pregnancies Signup and view all the answers

In gestational trophoblastic disease, how do abnormal trophoblast cells typically present?

As fluid-filled grape-sized vesicles Signup and view all the answers

What procedure may be necessary if a rough suture line on the fallopian tube is identified after an ectopic pregnancy?

Microsurgical technique for suturing Signup and view all the answers

What type of malignancy is associated with abnormal proliferation of trophoblastic villi?

Choriocarcinoma Signup and view all the answers

Which of the following describes the genetic composition of a complete mole in gestational trophoblastic disease?

An ovum fertilized by two sperm Signup and view all the answers

What is a common outcome for embryos in cases of gestational trophoblastic disease?

Embryos fail to develop beyond a primitive stage Signup and view all the answers

What is the condition characterized by the degeneration of trophoblastic villi?

Gestational trophoblastic disease Signup and view all the answers

What is the recommended birth method if the previa is over 30% and the fetus is mature?

C-sections Signup and view all the answers

Under what conditions can a woman with placenta previa be sent home after 24 to 48 hours of observation?

If fetal heart rate is stable Signup and view all the answers

What is a threatened miscarriage characterized by?

Vaginal bleeding during pregnancy Signup and view all the answers

What is the most frequent cause of miscarriage in the first trimester?

Abnormal fetal development Signup and view all the answers

What is a potential risk associated with low implantation of the placenta?

Congenital fetal anomalies Signup and view all the answers

When does bleeding with placenta previa typically begin during pregnancy?

Approximately week 30 Signup and view all the answers

Which factor may contribute to a threatened miscarriage?

Chromosomal aberration Signup and view all the answers

What usually happens to the fetus with deep placental implantation?

It tends to be expelled in natural childbirth. Signup and view all the answers

How is placenta previa most often detected during pregnancy?

Routine sonogram Signup and view all the answers

Which of the following is NOT a symptom of threatened miscarriage?

Cervical dilatation present Signup and view all the answers

What may be a reason for immediate birth to be indicated in cases of placenta previa?

Continuing bleeding Signup and view all the answers

What percentage of zygotes may never implant securely due to inadequate endometrial formation?

50% Signup and view all the answers

What is the purpose of administering betamethasone during care for placenta previa?

To enhance fetal lung maturity Signup and view all the answers

How does the body typically respond to control placental bleeding postchildbirth?

Uterine contractions Signup and view all the answers

What is a common assessment test conducted frequently during care for placenta previa?

Hemoglobin or hematocrit tests Signup and view all the answers

What role do immunologic factors play in miscarriages?

They may lead to rejection of the embryo. Signup and view all the answers

Study Notes

Threatened Miscarriage

Vaginal bleeding during pregnancy.
83% chance of pregnancy continuing.
Bleeding will not harm the baby, even if it’s heavy.
Symptoms include:
- Vaginal bleeding (usually bright red)
- Slight cramping, no cervical dilation present
- Mild period-type pain

Septic Abortion

Causes:
- Ruptured membranes (sometimes undetected)
- Sexually transmitted infections
- IUD left in place during pregnancy
- Fetal or placental tissue left in the uterus after miscarriage or abortion
- Illegal attempts to end pregnancy through tools, chemicals, or soaps in the uterus
Signs and symptoms:
- Fever
- Crampy abdomen
- Uterus tender to palpation

Isoimmunization (Rh Incompatibility)

Blood types determined by antigens on blood cells.
Rh factor is a protein on the surface of red blood cells.
Most people are Rh-positive.
Rh-negative individuals may develop antibodies to an Rh-positive fetus.
If a small amount of fetal blood enters the mother’s blood, her body may respond as if it were allergic.
Maternal antibodies may cross the placenta and attack fetal blood.
Maternal antibodies can break down the fetus's red blood cells, leading to anemia.
This is known as hemolytic disease or hemolytic anemia.
Severe cases can cause serious illness, brain damage, or death.

Ectopic Pregnancy

Implantation occurs outside the uterine cavity.
Most commonly located in a fallopian tube.
Approximately 95% occur in the fallopian tube.
80% occur in the ampullary portion, 12% in the isthmus, and 8% are interstitial or fimbrial.
An ectopic pregnancy is diagnosed with an early pregnancy ultrasound to date the pregnancy.
Between weeks 6 and 12, the zygote grows large enough to rupture the fallopian tube.
Tearing and destruction of blood vessels and bleeding result.
Rupture can cause severe intraperitoneal bleeding, especially in interstitial implantations.
The incidence of tubal pregnancies is highest in the ampullary area, where blood vessels are smaller and massive hemorrhage is less likely.
Constant bleeding from this area can lead to significant blood loss over time.
A ruptured ectopic pregnancy is serious, regardless of the implantation site.
Treatment involves laparoscopy to ligate bleeding vessels and remove or repair the damaged fallopian tube.
A suture line on the fallopian tube may lead to another tubal pregnancy, so the tube may be removed or microsurgical techniques employed for suturing.
Rh-negative women should receive RhIG/RhoGAM after an ectopic pregnancy for isoimmunization protection in future childbearing.

Gestational Trophoblastic Diseases (H-Mole)

Abnormal proliferation and degeneration of trophoblastic villi.
Cells fill with fluid and appear as clear fluid-filled, grape-sized vesicles.
The embryo fails to develop beyond a primitive start.
Abnormal trophoblast cells must be identified because of their association with choriocarcinoma, a rapidly metastasizing malignancy.
Can occur due to two sperm fertilizing an ovum or an ovum fertilized by one sperm with no meiosis.
Could also occur if one sperm supplies 23 chromosomes and an ovum without reduction division supplies 46 chromosomes.
Partial moles rarely lead to choriocarcinoma.

Placenta Previa

Placenta partially or completely covers the cervical opening.
Detected during routine sonograms.
Early ultrasound detections of low-lying placentas may migrate upward to a noncervical position.
Bleeding typically starts late in pregnancy (around week 30) when the lower uterine starts to differentiate from the upper segment and the cervix begins to dilate.
If the previa is under 30%, a vaginal birth may be possible.
If over 30%, and the fetus is mature, a cesarean birth is often safer for both mother and baby.

Continuing Care Measures for Placenta Previa

If labor has begun, bleeding is continuing, or the fetus is being compromised, birth must be accomplished regardless of gestational age.
Women remain in the hospital for 24-48 hours on bed rest for close observation.
If the bleeding stops, they can go home with a referral for bed rest and home care.
Frequent assessments of fetal heart sounds and laboratory tests (hemoglobin or hematocrit) are provided.
Betamethasone, a steroid that hastens fetal lung maturity, may be administered.

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Description

Test your knowledge on key obstetric complications such as threatened miscarriage, septic abortion, and isoimmunization. Learn about the symptoms, causes, and effects of these conditions on pregnancy. This quiz is essential for students in medical training or anyone interested in obstetric health.